scholarly journals Sudden unexpected, unexplained death in epilepsy autopsied patients

2001 ◽  
Vol 59 (1) ◽  
pp. 40-45 ◽  
Author(s):  
Sergio A. Antoniuk ◽  
Lubomira V. Oliva ◽  
Isac Bruck ◽  
Mariana Malucelli ◽  
Silvia Yabumoto ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Cause Of Death ◽  
Cerebral Edema ◽  
Postmortem Examination ◽  
Death Certificates ◽  
Unexplained Death ◽  
Seizure Event ◽  
National Mortality ◽  
Other Information ◽  
Patients With Epilepsy

Sudden unexpected, unexplained death in epilepsy (SUDEP) has been reported to be responsible for 2 to 17% of all deaths in patients with epilepsy. This study was conducted to determine the circumstances of SUDEP and the autopsy findings in these patients. Fifty-three individuals whose cause of death was related to epilepsy were identified and in 30 cases relatives or friends were interviewed about the circumstances of death and other information which allowed to classify the patients as SUDEP or not. The death certificates were also reviewed. We found 20 cases of SUDEP. Most of them were found dead lying on the bed with no evidence of seizure event, and most of them had pulmonary and/or cerebral edema as the cause of death. The incidence and the risk of SUDEP can only be fully ascertained if all sudden deaths had postmortem examination. Consensus in certifying SUDEP cases would allow better accuracy in national mortality rate.

scholarly journals ON THE USE OF ICD-10 REGULATIONS IN POSTMORTEM DIAGNOSIS, CODING AND SELECTION OF THE PRIMARY CAUSE OF DEATH IN COVID-19-RELATED TRAUMA AND DISEASES

2020 ◽  
Vol 6 (2) ◽  
pp. 4-7
Author(s):  
G. A. Aleksandrova ◽  
D. Sh. Vaysman
Keyword(s):  
Cause Of Death ◽  
Cerebrovascular Diseases ◽  
Medical Documentation ◽  
Death Certificates ◽  
Ministry Of Health ◽  
Postmortem Diagnosis ◽  
National Mortality ◽  
Icd 10 ◽  
Coronavirus Infection ◽  
Diagnosis Coding

Aim. For the purpose of ensuring the reliability of national mortality statistics, the present regulations set out to generalize current information on the preparation of primary medical documentation on the basis of requirements for filing death certificates, ICD-10 rules and recommendations by the Russian Ministry of Health.Material and methods. Existing requirements for filing death certificates, ICD-10 rules updated by WHO in 1996–2019 and recommendations by the Russian Ministry of Health were analysed.Results. The preparation of primary medical documentation, formulation of the concluding clinical, pathological, anatomical and forensic post-mortem diagnosis, issuance of death certificates, selection and coding of the primary cause of death should be carried out in accordance with the unified ICD-10 rules. Postmortem diagnosis should correspond to Volume 3 of ICD-10.Due to the pandemic of a new coronavirus infection, referred to as COVID-19, in 2019, WHO introduced changes to the ICD-10. COVID-19 was included in ICD-10 chapter XXII and received the codes of U07.1 and U07.2. COVID-19-accosiated deaths were divided into those where COVID-19 is determined to be the primary cause of death and those where COVID-19 falls into the category “other” causes.COVID-19 with fatal complications is most frequently selected as the primary cause of death in acute conditions, with concurrent chronic diseases (cancer, diabetes, chronic forms of ischemic and cerebrovascular diseases, etc.) being indicated as “other” causes of death in Part II of the death certificate. In the presence of trauma, poisoning, bleeding and conditions requiring emergency medical care, these conditions are selected as the primary cause of death, with COVID-19 being recorded in part II of the certificate.Conclusion. To provide reliable statistical information about mortality rates, executive authorities require the primary medical documentation filed in strict accordance with established rules. 

scholarly journals Profil Pasien Stroke Hemoragik yang Dirawat di ICU RSUP Prof. Dr. R.D. Kandou Manado Periode Desember 2014 sampai November 2015

e-CliniC ◽  
2016 ◽  
Vol 4 (1) ◽  
Author(s):  
Maria Estefina Siwi ◽  
Diana Lalenoh ◽  
Harold Tambajong
Keyword(s):  
Mortality Rate ◽  
Blood Vessels ◽  
Medical Record ◽  
Cause Of Death ◽  
Cerebral Edema ◽  
Hemorrhagic Stroke ◽  
Stroke Mortality ◽  
Probability Sampling ◽  
The Brain ◽  
Very High

Abstract: Hermorrhagic stroke is a disease caused by rupture of blood vessels of the brain that causes bleeding intro the brain parenchym tissue, cerebrospinal space around the brain or combination of both. Cause of death from hemorrhagic stroke is presence of complications or other comorbodities, like cerebral edema were reported the highest cause of death of hemorrhagic stroke. This study aimed to determine the profile of patients with hemorrhagic stroke in ICU, using descriptive retropective method. The samples were Prof. Dr. R.D. Kandou Manado ICU’s patients with hemorrhagic stroke based on the data in the medical record from December 2014 – November 2015. Hemorrhagic stroke mortality rate is very high (89%). From total 35 samples were examined, there 4 survivors (11%) and 31 deaths (89%), which consisted of 24 males (69%) and 11 females (31%). Most patients are 45-59 years old.Keywords: hemorrhagic stroke, ICUAbstrak: Stroke hemoragik adalah penyakit yang disebabkan oleh pecahnya pembuluh darah otak yang menyebabkan keluarnya darah ke jaringan parenkim otak, ruang serebrospinalis disekitar otak atau kombinasi keduanya. Penyebab kematian dari stroke hemoragik sendiri adalah adanya komplikasi atau penyakit penyerta lainnya, salah satu contohnya yaitu edema serebri yang dilaporkan merupakan penyebab kematian terbanyak. Penelitian ini bertujuan untuk mengetahui profil pasien stroke hemoragik yang dirawat di ICU RSUP Prof. Dr. R.D. Kandou Manado, menggunakan metode penelitian deskriptif retrospektif. Besar sampel ditentukan dengan metode non probability sampling yaitu purposive sampling. Sampel penelitian adalah pasien ICU RSUP Prof. Dr. R.D. Kandou Manado dengan diagnosa stroke hemoragik berdasarkan data di bagian Rekam Medik periode Desember 2014 sampai November 2015. Angka mortalitas stroke hemoragik sangatlah tinggi (89%). Total 35 sampel yang diteliti dengan 4 orang yang selamat (11%) dan 31 orang meninggal dunia (89%), terdiri dari 24 orang laki-laki (69%) dan 11 orang perempuan (31%). Sebagian besar adalah pasien umur 45-59 tahun.Kata kunci: stroke hemoragik, ruang rawat intensif

scholarly journals Death Certification Errors and the Effect on Mortality Statistics

2017 ◽  
Vol 132 (6) ◽  
pp. 669-675 ◽  
Author(s):  
Lauri McGivern ◽  
Leanne Shulman ◽  
Jan K. Carney ◽  
Steven Shapiro ◽  
Elizabeth Bundock
Keyword(s):  
Cause Of Death ◽  
Primary Objective ◽  
Error Rates ◽  
Death Certificates ◽  
Mortality Statistics ◽  
Manner Of Death ◽  
Registration System ◽  
National Mortality ◽  
Icd 10 ◽  
Medical Examiners

Objective: Errors in cause and manner of death on death certificates are common and affect families, mortality statistics, and public health research. The primary objective of this study was to characterize errors in the cause and manner of death on death certificates completed by non–Medical Examiners. A secondary objective was to determine the effects of errors on national mortality statistics. Methods: We retrospectively compared 601 death certificates completed between July 1, 2015, and January 31, 2016, from the Vermont Electronic Death Registration System with clinical summaries from medical records. Medical Examiners, blinded to original certificates, reviewed summaries, generated mock certificates, and compared mock certificates with original certificates. They then graded errors using a scale from 1 to 4 (higher numbers indicated increased impact on interpretation of the cause) to determine the prevalence of minor and major errors. They also compared International Classification of Diseases, 10th Revision (ICD-10) codes on original certificates with those on mock certificates. Results: Of 601 original death certificates, 319 (53%) had errors; 305 (51%) had major errors; and 59 (10%) had minor errors. We found no significant differences by certifier type (physician vs nonphysician). We did find significant differences in major errors in place of death ( P < .001). Certificates for deaths occurring in hospitals were more likely to have major errors than certificates for deaths occurring at a private residence (59% vs 39%, P < .001). A total of 580 (93%) death certificates had a change in ICD-10 codes between the original and mock certificates, of which 348 (60%) had a change in the underlying cause-of-death code. Conclusions: Error rates on death certificates in Vermont are high and extend to ICD-10 coding, thereby affecting national mortality statistics. Surveillance and certifier education must expand beyond local and state efforts. Simplifying and standardizing underlying literal text for cause of death may improve accuracy, decrease coding errors, and improve national mortality statistics.

scholarly journals Validity of death certificates for coding coronary heart disease as the cause of death in Bahrain

2000 ◽  
Vol 6 (4) ◽  
pp. 661-669
Author(s):  
R. Al Mahroos
Keyword(s):  
Public Health ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Cause Of Death ◽  
Death Certificate ◽  
Death Certificates ◽  
Hospital Records ◽  
Mortality Statistics ◽  
National Mortality ◽  
Underlying Cause Of Death

This study aimed to examine the accuracy of death certificates for coding coronary heart disease [CHD] as the underlying cause of death in Bahrain. Of the 1714 deaths occurring in Bahrain in 1993, 371 were classified as resulting from CHD. In this study the hospital diagnosis of 109 deaths [52 as CHD and 57 as other causes]were reviewed and re-diagnosed using hospital records. The coding of 459 death certificates [151 as CHD and 308 as other causes]by the Directorate of Public Health was similarly reviewed. The sensitivity and specificity of the hospital diagnosis were 76% and 72% respectively and those of the Directorate of Public Health were 85% and 89% respectively. National mortality statistics in Bahrain, which are based on death certificate data, may overestimate the frequency of CHD. Therefore, it is important that measures are taken to improve the accuracy of certification

scholarly journals Racism as a Leading Cause of Death: Measuring Excess Deaths in the US

2021 ◽  
Author(s):  
Daisy Massey ◽  
Jeremy Faust ◽  
Karen Dorsey ◽  
Yuan Lu ◽  
Harlan Krumholz
Keyword(s):  
Black Women ◽  
Mortality Rate ◽  
Black Men ◽  
Cause Of Death ◽  
White Women ◽  
Black People ◽  
Mortality Rates ◽  
White People ◽  
The Us ◽  
Excess Deaths

Background: Excess death for Black people compared with White people is a measure of health equity. We sought to determine the excess deaths under the age of 65 (<65) for Black people in the United States (US) over the most recent 20-year period. We also compared the excess deaths for Black people with a cause of death that is traditionally reported. Methods: We used the Multiple Cause of Death 1999-2019 dataset from the Center of Disease Control (CDC) WONDER to report age-adjusted mortality rates among non-Hispanic Black (Black) and non-Hispanic White (White) people and to calculate annual age-adjusted <65 excess deaths for Black people from 1999-2019. We measured the difference in mortality rates between Black and White people and the 20-year and 5-year trends using linear regression. We compared age-adjusted <65 excess deaths for Black people to the primary causes of death among <65 Black people in the US. Results: From 1999 to 2019, the age-adjusted mortality rate for Black men was 1,186 per 100,000 and for White men was 921 per 100,000, for a difference of 265 per 100,000. The age-adjusted mortality rate for Black women was 802 per 100,000 and for White women was 664 per 100,000, for a difference of 138 per 100,000. While the gap for men and women is less than it was in 1999, it has been increasing among men since 2014. These differences have led to many Black people dying before age 65. In 1999, there were 22,945 age-adjusted excess deaths among Black women <65 and in 2019 there were 14,444, deaths that would not have occurred had their risks been the same as those of White women. Among Black men, 38,882 age-adjusted excess <65 deaths occurred in 1999 and 25,850 in 2019. When compared to the top 5 causes of deaths among <65 Black people, death related to disparities would be the highest mortality rate among both <65 Black men and women. Comment: In the US, over the recent 20-year period, disparities in mortality rates resulted in between 61,827 excess deaths in 1999 and 40,294 excess deaths in 2019 among <65 Black people. The race-based disparity in the US was the leading cause of death among <65 Black people. Societal commitment and investment in eliminating disparities should be on par with those focused on other leading causes of death such as heart disease and cancer.

scholarly journals Minimally invasive autopsy for fetuses and children based on a combination of post-mortem MRI and endoscopic examination: a feasibility study

2019 ◽  
Vol 23 (46) ◽  
pp. 1-104 ◽  
Author(s):  
Celine Lewis ◽  
John C Hutchinson ◽  
Megan Riddington ◽  
Melissa Hill ◽  
Owen J Arthurs ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Cause Of Death ◽  
Clinical Indication ◽  
Religious Leaders ◽  
Training Requirements ◽  
Less Invasive ◽  
Sudden Unexplained Death ◽  
Unexplained Death ◽  
Minimally Invasive Autopsy ◽  
Autopsy Data

BackgroundLess invasive perinatal and paediatric autopsy methods, such as imaging alongside targeted endoscopy and organ biopsy, may address declining consent rates for traditional autopsy, but their acceptability and accuracy are not known.ObjectivesThe aims of this study were to provide empirical data on the acceptability and likely uptake for different types of autopsy among key stakeholders (study 1); and to analyse existing autopsy data sources to provide estimates of the potential efficacy of less invasive autopsy (LIA) and its projected utility in clinical practice (study 2).Review methodsStudy 1: this was a mixed-methods study. Parents were involved in research design and interpretation of findings. Substudy 1: a cross-sectional survey of 859 parents who had experienced miscarriage, termination of pregnancy for fetal anomaly, stillbirth, infant or child death, and interviews with 20 responders. Substudy 2: interviews with 25 health professionals and four coroners. Substudy 3: interviews with 16 religious leaders and eight focus groups, with 76 members of the Muslim and Jewish community. Study 2: a retrospective analysis of national data in addition to detailed information from an existing in-house autopsy database of > 5000 clinical cases that had undergone standard autopsy to determine the proportion of cases by clinical indication group for which tissue sampling of specific internal organs significantly contributed to the diagnosis.ResultsSubstudy 1: 91% of participants indicated that they would consent to some form of LIA, 54% would consent to standard autopsy, 74% to minimally invasive autopsy (MIA) and 77% to non-invasive autopsy (NIA). Substudy 2: participants viewed LIA as a positive development, but had concerns around the limitations of the technology and de-skilling the workforce. Cost implications, skills and training requirements were identified as implementation challenges. Substudy 3: religious leaders agreed that NIA was religiously permissible, but MIA was considered less acceptable. Community members indicated that they might consent to NIA if the body could be returned for burial within 24 hours. Study 2: in 5–10% of cases of sudden unexplained death in childhood and sudden unexplained death in infants, the final cause of death is determined by routine histological sampling of macroscopically normal organs, predominantly the heart and lungs, and in this group routine histological sampling therefore remains an important aspect of investigation. In contrast, routine histological examination of macroscopically normal organs rarely (< 0.5%) provides the cause of death in fetal cases, making LIA and NIA approaches potentially highly applicable.LimitationsA key limitation of the empirical research is that it is hypothetical. Further research is required to determine actual uptake. Furthermore, because of the retrospective nature of the autopsy data set, findings regarding the likely contribution of organ sampling to final diagnosis are based on extrapolation of findings from historical autopsies, and prospective data collection is required to validate the conclusions.ConclusionsLIA is viable and acceptable (except for unexplained deaths), and likely to increase uptake. Further health economic, performance and implementation studies are required to determine the optimal service configuration required to offer this as routine clinical care.FundingThe National Institute for Health Research Health Technology Assessment programme.

scholarly journals Gastrointestinal Manifestations in Mucopolysaccharidosis Type III: Review of Death Certificates and the Literature

2021 ◽  
Vol 10 (19) ◽  
pp. 4445
Author(s):  
Sophie Thomas ◽  
Uma Ramaswami ◽  
Maureen Cleary ◽  
Medeah Yaqub ◽  
Eva M. Raebel
Keyword(s):  
Cause Of Death ◽  
Causes Of Death ◽  
Clinical Feature ◽  
Mucopolysaccharidosis Type ◽  
Death Certificates ◽  
Type Iii ◽  
Mucopolysaccharidosis Type Iii ◽  
Gi Symptoms ◽  
Tract Infections ◽  
Mps Iii

Background: Mucopolysaccharidosis type III (MPS III, Sanfilippo disease) is a life-limiting recessive lysosomal storage disorder caused by a deficiency in the enzymes involved in degrading glycosaminoglycan heparan sulfate. MPS III is characterized by progressive deterioration of the central nervous system. Respiratory tract infections have been reported as frequent and as the most common cause of death, but gastrointestinal (GI) manifestations have not been acknowledged as a cause of concern. The aim of this study was to determine the incidence of GI problems as a primary cause of death and to review GI symptoms reported in published studies. Methods: Causes of death from 221 UK death certificates (1957–2020) were reviewed and the literature was searched to ascertain reported GI symptoms. Results: GI manifestations were listed in 5.9% (n = 13) of death certificates. Median (IQR) age at death was 16.7 (5.3) years. Causes of death included GI failure, GI bleed, haemorrhagic pancreatitis, perforation due to gastrostomies, paralytic ileus and emaciation. Twenty-one GI conditions were reported in 30 studies, mostly related to functional GI disorders, including diarrhoea, dysphagia, constipation, faecal incontinence, abdominal pain/distension and cachexia. Conclusions: GI manifestations may be an under-recognized but important clinical feature of MPS III. Early recognition of GI symptoms and timely interventions is an important part of the management of MPS III patients.

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