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Причины смерти и методы их анализа

Причины смерти и методы их анализа. Н.С. Гаврилова. Causes of death and their classification. Established by the World Health Organization as International Classification of Diseases (ICD)

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Причины смерти и методы их анализа

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  1. Причины смерти и методы их анализа Н.С. Гаврилова

  2. Causes of death and their classification • Established by the World Health Organization as International Classification of Diseases (ICD) • Has several revisions. The most recent revision is the 10th revision. Adopted by most countries in the mid 1990s

  3. Classification of causes of death in Russia • Classification of causes of death used in the Soviet statistical forms was different from WHO classification. • Form #5 (later called form C51) had 185 causes of death. • Main differences between WHO and Soviet classification are found in the groups of CVD and injuries

  4. New classification of causes of death in Russia • After dissolution of the Soviet Union most FSU countries continued to use the old classification of causes of death • In 1999 Russia adopted a new classification of causes of death corresponding to the 10th ICD revision • Still incompatible with the WHO classification

  5. Major causes of death within the group of injuries. Men Иванова и др., Demoscope Weekly, N181-182, 2004

  6. Major causes of death within the group of injuries. Women Иванова и др., Demoscope Weekly, N181-182, 2004

  7. Degradation of mortality statistics in Russia

  8. Pace of Growth of Age-Adjusted Mortality in 1989-2000 for Classes of Causes of Death

  9. Proportion of deaths from ill-defined conditions is a measure of quality of mortality statisticsProportion higher than 5% indicates poor qualityIn developed countries most deaths from ill-defined conditions are diagnosed at older ages

  10. Is this increase in mortality from ill-defined conditions related to more cases of deaths from senility?

  11. Age Profile of Mortality from Ill-Defined Conditions in Russia Males Females

  12. Top Five Causes of Death for Young Adult Males (20-24)

  13. Top Five Causes of Death for Young Adult Females (20-24)

  14. What Causes of Death Are Hidden Behind the Ill-Defined Conditions?

  15. We Used Individual Death Certificates With More Detailed Description of Circumstances of Death Collected by Kirov Department of HealthKirov is a Typical Russian Region with Lower than Average Mortality from Ill-Defined Conditions

  16. Age-Adjusted Mortality from Injuries in 1996 for Russian Males Aged 0-64 yearsData from the WebAtlas Project (http://sci.aha.ru/ATL)

  17. Deaths from Ill-Defined Conditions in Kirov Region of Russia in 2003 • Sudden infant death (R95) 3.3% • Decomposition in water (river, well, pond) (R99) 13.0% • Decomposition at home (R99) 53.5% • Decomposition in garden, summer house (R99) 1.7% • Decomposition in forest or field (R99) 6.0% • Decomposition in nonresidential building, on the street (R99) 12.3% • Decomposition in water pipe (R99) 0.7% • Decomposition on the cemetery (R99) 0.3% • Decomposition in bath, lavatory or barn (R99) 1.0% • Decomposition in other place (R99) 5.5% • unknown (R99) 2.3% • senility (R54) 0.3%

  18. Mortality in Moscow city

  19. Ill-defined conditions and external deaths of undetermined intent are two sides of the same coinIt appears that both causes of death may be used for concealing criminal cases of violent death

  20. Top Five Causes of External Mortality in Russia and Moscow in 2001

  21. Autopsies in Russia • Autopsies are used to verify cause of death • Autopsy is mandatory for violent death, death of woman during pregnancy, labor or postpartum period, death of infant below 1 year, death from cancer not supported morphologically, death from any infectious disease

  22. Situation with medical examiner services • Only 34-48% of jobs are filled by physicians • 38-54% of jobs are filled by histologists • 35% of workers reached retirement age

  23. Средний ожидаемый возраст смерти по причинам, женщины России Васин С., доклад в Киеве 2006

  24. Вероятность для новорожденного умереть на протяжении жизни от семи групп причин смерти (на 100 родившихся), мужчины России БСК и новообр. – правая ось Васин С., доклад в Киеве 2006

  25. Сравнение структуры смертности мужчин России и Западных стран. 1965 год Васин С., доклад в Киеве 2006

  26. Сравнение структуры смертности мужчин России и Западных стран. 2004 год Васин С., доклад в Киеве 2006

  27. Decomposition of the U.S.-Russia gap in life expectancy by cause USA – 1999; Russia – 2001. Source: Shkolnikov et a. Mortality reversal in Russia.

  28. Decomposition of the U.S.-Russia gap in life expectancy by cause USA – 1999; Russia – 2001. Source: Shkolnikov et a. Mortality reversal in Russia.

  29. Contribution of different causes of death to changes in LE, men

  30. Contribution of different causes of death to changes in LE, women

  31. Age and cause components of LE increase due to anti-alcohol campaign: Men

  32. Age and cause components of LE increase due to anti-alcohol campaign: Women

  33. Contribution of causes of death to40e20(CA) - 40e20(Slav)Males (total difference = 2.90 years)

  34. Contribution of causes of death to40e20(CA) - 40e20(Slav)Females (total difference = .28 years)

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