Problems in cause-of-death statistics in Japan revealed by the statistical study on unnatural deaths in 1990

1990年非自然死亡统计研究揭示日本死因统计存在的问题

• 批准号: 03304033
• 负责人: MIZOI Yasuhiko
• 金额: $ 3.58万
• 依托单位: Osaka Medical College
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Co-operative Research (A)
• 财政年份: 1991
• 资助国家: 日本
• 起止时间: 1991 至 1992
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-03304033/
• 关键词: Cause-of-death statistics; International Classification of Diseases (ICD); Unnatural death; Death certificate; Medical examiner system; Ischemic heart diseases; Heart failure

1. Cases of unnatural death during the course of 1990 were statistically investigated in six prefectures in terms of International Classification of Diseases-9 (ICD-9). The four prefectures, Tokyo, Kanagawa,Osaka and Hyogo, have medical examiner system (MES), whereas the other two, Shiga and Kagawa, have not.2. The total cases investigated were 23833. Numbers and rates by causes of death were summarized as follows: 14042 (58.9%) disease cases, 143 (0.6%) accidental poisoning cases, 3575 (15.5%) other accidental cases, 4576 (19.2%) suicide cases, 238 (1.0%) homicide cases, 1144 (4.8%) unknown cases.3. Out of the disease cases, 8549 (60.9%) and 5493 (39.1%) were recorded in the regions with MES and without MES, respectively.4. When disease cases were classified by regions with and without MES, in the former regions, 69.4% were due to diseases of the circulatory systems, 9.4% to diseases of the digestive system, 8.3% to diseases of the respiratory system, and 12.9% to other diseases, wher … More eas in the latter regions, the rates were 84.7%, 3.9%, 3.0%, and 8.5%, respectively.5. The rates by detailed classification of diseases of the circulatory system in the regions with MES were estimated as follows: Ischemic heart diseases at 52.5%, "heart failure" at 10.2%, other heart diseases at 5.2%, subarachnoid hemorrhage at 4.3%, cerebral hemorrhage at 14.0%, other cerebro-vascular diseases at 3.5%, and other diseases of the circulatory system at 10.4%. On the other hand, those rates in the regions without MES were, 21.7%, 60.3%, 1.9%, 2.4%, 4.5%, 5.8%, and 3.4%, respectively.6. Autopsy rates of the disease cases were estimated at 50.2% in the regions with MES and 1.9% in the regions without MES.7. As mentioned above, the rates by organ system of deaths from diseases and those by detailed classification of deaths from the circulatory system showed remarked differences between the two regions. These findings indicate that medical examiner system is crucial in determining correct cause-of-death and in getting accurate cause-of-death statistics.8. Strikingly higher rate of "heart failure" in the regions without MES seems to be ascribed not only to low autopsy rate of deaths from diseases but also to little recognition of the system of ICD-9 by doctors conducting a postmortem examination. The latter problem will have to be discussed in terms of medical education. Less

1. 1990年期间，根据国际疾病分类-9（ICD-9）对六个县的非正常死亡病例进行了统计调查。东京、神奈川、大坂和兵库四个县都有体检医师制度，而另外两个县滋贺和香川没有。调查的案件总数为23 833起。按死因分类的死亡人数和死亡率总结如下：疾病14042例（58.9%），意外中毒143例（0.6%），其他意外3575例（15.5%），自杀4576例（19.2%），他杀238例（1.0%），死因不明1144例（4.8%）。在这些病例中，有MES和无MES的地区分别记录了8549例（60.9%）和5493例（39.1%）。按有无MES的地区分类，在前者，69.4%的疾病是循环系统疾病，9.4%是消化系统疾病，8.3%是呼吸系统疾病，12.9%是其他疾病，而后者则是呼吸系统疾病。 ...更多信息 在后四个地区，分别为84.7%、3.9%、3.0%和8.5%.按循环系统疾病的详细分类，MES地区的发病率估计如下：缺血性心脏病占52.5%，“心力衰竭”占10.2%，其他心脏病占5.2%，蛛网膜下腔出血占4.3%，脑出血占14.0%，其他脑血管疾病占3.5%，其他循环系统疾病占10.4%。另一方面，在没有MES的地区，这些比率分别为21.7%、60.3%、1.9%、2.4%、4.5%、5.8%和3.4%。在有MES的地区，疾病病例的尸检率估计为50.2%，在没有MES的地区为1.9%。如上所述，按器官系统分类的疾病死亡率和按循环系统详细分类的死亡率显示，两个区域之间存在显著差异。这些研究结果表明，法医系统在确定正确的死因和获得准确的死因鉴定方面至关重要。在没有MES的地区，“心力衰竭”的发病率明显较高，这似乎不仅是由于疾病死亡的尸检率低，而且也是由于医生进行尸检时对ICD-9系统认识不足。后一个问题将不得不从医学教育的角度来讨论。少

项目成果

溝井 泰彦,他: "国際疾病分類からみた日本の死因調査の現状と問題点" 日本法医学雑誌. 47. (1993)

Yasuhiko Mizoi等人：“从国际疾病分类的角度看日本死因调查的现状和问题”《日本法医学杂志》47。（1993年）

Yasuhiko Mizoi et al.: "Problems of Cause-of-death Statistics in Japan." The Japanese Journal of Legal Medicine. 47 Supplement. P.106 (1993)

Yasuhiko Mizoi 等人：“日本死因统计问题”。

溝井 泰彦 他: "国際疾病分類からみた日本の死因調査の現状と問題点" 日本法医学雑誌. 47補冊号. 106 (1993)

Yasuhiko Mizoi 等：“从国际疾病分类的角度看日本死亡调查的现状和问题”《日本法医学杂志》第 47 期增刊 106（1993 年）。