Place, time and certified cause of death in people who die after hospital admission for myocardial infarction or stroke
Place, time and certified cause of death in people who die after hospital admission for myocardial infarction or stroke
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DOI：
10.1093/eurpub/14.4.338
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发表时间：
2004-12-01
影响因子：
4.4
通讯作者：
Griffith, M
中科院分区：
文献类型：
--
作者：
Goldacre, MJ;Roberts, SE;Griffith, M
背景：入院后因心肌梗塞(MI)或中风而死亡的常规统计数据有两个不确定的方面：i)大多数死亡是否发生在入院期间本身，而不是出院后；ii)大多数死亡是否在死亡证明上分别被证明为MI或中风。方法：采用关联医院和死亡率统计方法，对35~74岁人群因心肌梗塞或卒中入院后的死亡时间、地点和确诊死因进行分析。结果：在因心肌梗塞入院一年内死亡的7964人中，5686人(71.4%)发生在入院后30天内。其中，4856例(85.4%)发生在首次住院期间。在因中风入院一年内死亡的7070人中，4905人(69.4%)在30天内死亡，其中4509人(91.9%)发生在首次入院期间。正如预期的那样，死亡间隔时间超过30天的主要发生在出院后。在心肌梗死和中风后30天内的死亡中，分别有85.2%和80.0%的患者被证实为心肌梗死或中风的潜在死因。结论：在没有死亡证明记录的情况下，仅计算住院死亡率，就可以确定大多数死亡发生在入院30天内。尽管如此，即使在这段时间内，联系也增加了查明的完整性。没有关联的数据在较长的时间间隔内识别死亡是不可靠的。作为基本原因的心肌梗塞和中风的常规死亡统计数据可靠地包括了每种疾病入院后30天内发生的大多数死亡。
Background: Two areas of uncertainty about routine statistics for mortality after hospital admission for myocardial infarction (MI) or stroke are i) whether most deaths occur in the admission episode itself rather than after discharge, and ii) whether most deaths are certified on death certificates as, respectively, MI or stroke. Methods: Use of linked hospital and mortality statistics to analyse the time, place and certified cause of death in people aged 35-74 after admission for MI or stroke. Results: Of 7,964 deaths within a year of admission for MI, 5,686 (71.4%) occurred within 30 days of admission. Of these, 4,856 (85.4%) occurred during the initial hospital admission. Of 7,070 deaths within a year of admission for stroke, 4,905 (69.4%) were within 30 days, and 4,509 (91.9%) of these occurred during the initial admission. As expected, deaths at longer intervals than 30 days occurred mainly after discharge. Of deaths within 30 days of MI and stroke, 85.2% and 80.0%, respectively, were certified with MI or stroke as the underlying cause of death. Conclusion: In-hospital death rates alone, calculated without record linkage to death certificates, would have identified most deaths that occurred within 30 days of admission. Nonetheless, linkage added to completeness of ascertainment even within this time period. Data without linkage are unreliable in identifying deaths at longer time intervals. Routine mortality statistics for MI and stroke, as the underlying cause, reliably included most deaths that occurred within 30 days of admission for each respective disease.