Cardiovascular mortality and impact of corrective techniques for dealing with underreported and ill-defined deaths
Cardiovascular mortality and impact of corrective techniques for dealing with underreported and ill-defined deaths
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DOI：
10.1590/s1020-49892012000900005
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发表时间：
2012-09-01
期刊：
影响因子：
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通讯作者：
Gonçalves, Maria Jacirema
中科院分区：
文献类型：
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作者：
Soares, David Arnaud;Gonçalves, Maria Jacirema
Objective.在1980年至2007年期间，在巴西亚马逊州马瑙斯市，确定纠正技术对心血管疾病、缺血性心脏病和脑血管疾病死亡率趋势的影响。从统一保健系统的信息技术部获得数据，并采取了以下步骤：（1）按比例重新分配死亡记录，但不考虑年龄和/或性别;（2）在死因已知的人中重新分配定义不清的死亡;（3）治疗和重新分配心脏病学中所谓的“垃圾代码”;（4）用间接技术纠正死亡漏报。在步骤1和2以及步骤3和4中处理的记录分别生成了基础率、调整率以及调整和校正率，并根据性别和年龄队列进行分析;随后，通过直接方法对其进行标准化。采用简单线性回归进行趋势分析。死亡率信息系统的原始数据低估了心脏病死亡率，主要是从2000年开始。关于一段时间内的趋势，与基准发病率相比，调整和校正后的发病率表明：心血管疾病总体下降趋势减弱;缺血性心脏病下降趋势加剧;脑血管疾病发病率在此期间保持稳定。这一修正使得有可能查明未计算的超额死亡人数，从而产生更可靠的调整和修正死亡率。
Objective. Identify the impact of corrective techniques in the mortality rate trends for cardiovascular disease, ischemic heart diseases, and cerebrovascular diseases, in the City of Manaus, State of Amazonas, Brazil, between 1980 and 2007.Methods. Data were obtained from the Unified Health System's Information Technology Department and the following steps undertaken: (1) proportional redistribution of death records, but without taking into account age and/or sex; (2) redistribution of ill-defined deaths among those whose cause is known; (3) treatment and reallocation of so-called "junk codes" in cardiology; and (4) correction of underrecordings of deaths by indirect techniques. Records treated in steps 1 and 2, and steps 3 and 4 together, generated base rates, adjusted rates, and adjusted and corrected rates, respectively, which were analyzed according to sex and age cohort; subsequently, they were standardized by the direct method. Simple linear regression was used for trend analysis.Results. The Mortality Information System's raw data underestimated death from heart diseases, mainly starting in the year 2000. With regard to the trend over time, the adjusted and corrected rates, compared to the base rates, pointed to the following: attenuation of the downward trend for cardiovascular diseases as a whole; accentuation of the downward trend for ischemic heart diseases; and stability in the rates for cerebrovascular diseases during the period.Conclusions. This correction made it possible to identify an excess of deaths that had not been computed, generating more reliable adjusted and corrected death rates.