Cause-specific mortality patterns among hospital deaths in Thailand: validating routine death certification.
Cause-specific mortality patterns among hospital deaths in Thailand: validating routine death certification.
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DOI：
10.1186/1478-7954-8-12
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发表时间：
2010-05-18
影响因子：
3.3
通讯作者：
Lopez AD
中科院分区：
文献类型：
--
作者：
Pattaraarchachai J;Rao C;Polprasert W;Porapakkham Y;Pao-In W;Singwerathum N;Lopez AD
在泰国，35%的死亡发生在医院，死亡原因由主治医生进行医学证明。大约15%的医院死亡登记为非特异性诊断，尽管使用医疗记录中的信息可能更准确。此外，在登记时将诊断结果从泰文转录成英文所产生的问题造成了登记数据准确性的不确定性，即使是具体的死亡原因。本文报告了一项研究的结果，以衡量在2005年期间发生在泰国医院的死亡样本登记诊断的有效性。选择了4，644例医院死亡的样本，并对每个病例的医疗记录进行了审查。使用病历摘要、专家医师审查和独立裁定的过程来选择和编码潜在死亡原因，以获得参考诊断。从登记数据中计算医院死亡的主要原因的验证特征，并确定登记诊断的错误分类模式。研究结果用于估计泰国医院死亡的特定原因死亡率模式。在研究样本中，有3，316例死亡病例的医疗记录。失访在年龄、性别和原因方面无差异。医疗记录审查确定了大多数死亡的具体根本原因，这些死亡最初被指定为不明确的原因，以及那些最初被指定为特定原因组的剩余类别的死亡。与样本的登记数据相比，我们发现因中风、缺血性心脏病、交通事故、艾滋病毒/艾滋病、糖尿病、肝病和慢性阻塞性肺病而在医院死亡的相对比例有所增加。关于医院内死亡原因的登记数据在用于流行病学研究或公共卫生政策之前需要定期核实。需要简化死亡证明和死亡根本原因编码程序，以提高登记数据的可靠性。这项研究对死因特异性死亡率的估计将为疾病负担估计提供信息，并指导泰国采取干预措施，以减少医院中可避免的死亡率。
In Thailand, 35% of all deaths occur in hospitals, and the cause of death is medically certified by attending physicians. About 15% of hospital deaths are registered with nonspecific diagnoses, despite the potential for greater accuracy using information available from medical records. Further, issues arising from transcription of diagnoses from Thai to English at registration create uncertainty about the accuracy of registration data even for specified causes of death. This paper reports findings from a study to measure validity of registered diagnoses in a sample of deaths that occurred in hospitals in Thailand during 2005. A sample of 4,644 hospital deaths was selected, and for each case, medical records were reviewed. A process of medical record abstraction, expert physician review, and independent adjudication for the selection and coding of underlying causes of death was used to derive reference diagnoses. Validation characteristics were computed for leading causes of hospital deaths from registration data, and misclassification patterns were identified for registration diagnoses. Study findings were used to estimate cause-specific mortality patterns for hospital deaths in Thailand. Adequate medical records were available for 3,316 deaths in the study sample. Losses to follow up were nondifferential by age, sex, and cause. Medical records review identified specific underlying causes for the majority of deaths that were originally assigned ill-defined causes as well as for those originally assigned to residual categories for specific cause groups. In comparison with registration data for the sample, we found an increase in the relative proportion of deaths in hospitals due to stroke, ischemic heart disease, transport accidents, HIV/AIDS, diabetes, liver diseases, and chronic obstructive pulmonary disease. Registration data on causes for deaths occurring in hospitals require periodic validation prior to their use for epidemiological research or public health policy. Procedures for death certification and coding of underlying causes of death need to be streamlined to improve reliability of registration data. Estimates of cause-specific mortality from this research will inform burden of disease estimation and guide interventions to reduce avoidable mortality in hospitals in Thailand.
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影响因子：
2.3
作者：
Zhu, Jun-ren;Tomlinson, Brian;Sriratanasathavorn, Charn
通讯作者：
Sriratanasathavorn, Charn
影响因子：
3.3
作者：
Polprasert W;Rao C;Adair T;Pattaraarchachai J;Porapakkham Y;Lopez AD
通讯作者：
Lopez AD
影响因子：
3.3
作者：
Rao C;Porapakkham Y;Pattaraarchachai J;Polprasert W;Swampunyalert N;Lopez AD
通讯作者：
Lopez AD
影响因子：
--
作者：
KING, MB
通讯作者：
KING, MB
影响因子：
7.7
作者：
Rao, Chalapati;Yang, Gonghuan;Lopez, Alan D.
通讯作者：
Lopez, Alan D.