scholarly journals Improving Diagnostic Classification of Stillbirths and Neonatal Deaths Using ICD-PM (International Classification of Diseases for Perinatal Mortality) Codes: Validation Study

10.2196/20071 ◽  
2020 ◽  
Vol 8 (8) ◽  
pp. e20071
Author(s):  
Hiu Mei Luk ◽  
Emma Allanson ◽  
Wai-Kit Ming ◽  
Wing Cheong Leung
Keyword(s):  
Perinatal Mortality ◽  
Perinatal Death ◽  
International Classification Of Diseases ◽  
Diagnostic Classification ◽  
Code System ◽  
Perinatal Deaths ◽  
Neonatal Deaths ◽  
Classification Of Diseases ◽  
Death Data

Background Stillbirths and neonatal deaths have long been imperfectly classified and recorded worldwide. In Hong Kong, the current code system is deficient (>90% cases with unknown causes) in providing the diagnoses of perinatal mortality cases. Objective The objective of this study was to apply the International Classification of Diseases for Perinatal Mortality (ICD-PM) system to existing perinatal death data. Further, the aim was to assess whether there was any change in the classifications of perinatal deaths compared with the existing classification system and identify any areas in which future interventions can be made. Methods We applied the ICD-PM (with International Statistical Classification of Diseases and Related Health Problems, 10th Revision) code system to existing perinatal death data in Kwong Wah Hospital, Hong Kong, to improve diagnostic classification. The study included stillbirths (after 24 weeks gestation) and neonatal deaths (from birth to 28 days). The retrospective data (5 years) from May 1, 2012, to April 30, 2017, were recoded by the principal investigator (HML) applying the ICD-PM, then validated by an overseas expert (EA) after she reviewed the detailed case summaries. The prospective application of ICD-PM from May 1, 2017, to April 30, 2019, was performed during the monthly multidisciplinary perinatal meetings and then also validated by EA for agreement. Results We analyzed the data of 34,920 deliveries, and 119 cases were included for analysis (92 stillbirths and 27 neonatal deaths). The overall agreement with EA of our codes using the ICD-PM was 93.2% (111/119); 92% (78/85) for the 5 years of retrospective codes and 97% (33/34) for the 2 years of prospective codes (P=.44). After the application of the ICD-PM, the overall proportion of unknown causes of perinatal mortality dropped from 34.5% (41/119) to 10.1% (12/119) of cases (P<.001). Conclusions Using the ICD-PM would lead to a better classification of perinatal deaths, reduce the proportion of unknown diagnoses, and clearly link the maternal conditions with these perinatal deaths.

scholarly journals Improving Diagnostic Classification of Stillbirths and Neonatal Deaths Using ICD-PM (International Classification of Diseases for Perinatal Mortality) Codes: Validation Study (Preprint)

2020 ◽  
Author(s):  
Hiu Mei Luk ◽  
Emma Allanson ◽  
Wai-Kit Ming ◽  
Wing Cheong Leung
Keyword(s):  
Perinatal Mortality ◽  
Perinatal Death ◽  
International Classification Of Diseases ◽  
Diagnostic Classification ◽  
Code System ◽  
Perinatal Deaths ◽  
Neonatal Deaths ◽  
Classification Of Diseases ◽  
Death Data

BACKGROUND Stillbirths and neonatal deaths have long been imperfectly classified and recorded worldwide. In Hong Kong, the current code system is deficient (&gt;90% cases with unknown causes) in providing the diagnoses of perinatal mortality cases. OBJECTIVE The objective of this study was to apply the International Classification of Diseases for Perinatal Mortality (ICD-PM) system to existing perinatal death data. Further, the aim was to assess whether there was any change in the classifications of perinatal deaths compared with the existing classification system and identify any areas in which future interventions can be made. METHODS We applied the ICD-PM (with International Statistical Classification of Diseases and Related Health Problems, 10th Revision) code system to existing perinatal death data in Kwong Wah Hospital, Hong Kong, to improve diagnostic classification. The study included stillbirths (after 24 weeks gestation) and neonatal deaths (from birth to 28 days). The retrospective data (5 years) from May 1, 2012, to April 30, 2017, were recoded by the principal investigator (HML) applying the ICD-PM, then validated by an overseas expert (EA) after she reviewed the detailed case summaries. The prospective application of ICD-PM from May 1, 2017, to April 30, 2019, was performed during the monthly multidisciplinary perinatal meetings and then also validated by EA for agreement. RESULTS We analyzed the data of 34,920 deliveries, and 119 cases were included for analysis (92 stillbirths and 27 neonatal deaths). The overall agreement with EA of our codes using the ICD-PM was 93.2% (111/119); 92% (78/85) for the 5 years of retrospective codes and 97% (33/34) for the 2 years of prospective codes (<i>P</i>=.44). After the application of the ICD-PM, the overall proportion of unknown causes of perinatal mortality dropped from 34.5% (41/119) to 10.1% (12/119) of cases (<i>P</i>&lt;.001). CONCLUSIONS Using the ICD-PM would lead to a better classification of perinatal deaths, reduce the proportion of unknown diagnoses, and clearly link the maternal conditions with these perinatal deaths.

scholarly journals The application of WHO ICD-PM: Feasibility for the classification of timing and causes of perinatal deaths in a busy birth centre in a low-income country

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0245196
Author(s):  
Natasha Housseine ◽  
Anne Snieder ◽  
Mithle Binsillim ◽  
Tarek Meguid ◽  
Joyce L. Browne ◽  
...  
Keyword(s):  
Perinatal Mortality ◽  
Low Income ◽  
Perinatal Death ◽  
Descriptive Analysis ◽  
Accurate Determination ◽  
Referral Hospital ◽  
Maternal Complications ◽  
Perinatal Deaths ◽  
Neonatal Deaths

Objective To assess the feasibility of the application of International Classification of Diseases-10—to perinatal mortality (ICD-PM) in a busy low-income referral hospital and determine the timing and causes of perinatal deaths, and associated maternal conditions. Design Prospective application of ICD-PM. Setting Referral hospital of Mnazi Mmoja Hospital, Zanzibar, United Republic of Tanzania. Population Stillbirths and neonatal deaths with a birth weight above 1000 grams born between October 16th 2017 to May 31st 2018. Methods Clinical information and an adapted WHO ICD-PM interactive excel-based system were used to capture and classify the deaths according to timing, causes and associated maternal complications. Descriptive analysis was performed. Main outcome measures Timing and causes of perinatal mortality and their associated maternal conditions. Results There were 661 perinatal deaths of which 248 (37.5%) were neonatal deaths and 413 (62.5%) stillbirths. Of the stillbirths, 128 (31%) occurred antepartum, 129 (31%) intrapartum and for 156 (38%) the timing was unknown. Half (n = 64/128) of the antepartum stillbirths were unexplained. Two-thirds (67%, n = 87/129) of intrapartum stillbirths followed acute intrapartum events, and 30% (39/129) were unexplained. Of the neonatal deaths, 40% died after complications of intrapartum events. Conclusion Problems of documentation, lack of perinatal death audits, capacity for investigations, and guidelines for the unambiguous objective assignment of timing and primary causes of death are major threats for accurate determination of timing and specific primary causes of perinatal deaths.

scholarly journals KEMATIAN PERINATAL DI BLU RSU PROF. DR. R. D. KANDOU MANADO

2013 ◽  
Vol 1 (1) ◽  
Author(s):  
Mercy Tumundo ◽  
Hermie Tendean ◽  
Eddy Suparman
Keyword(s):  
Mortality Rate ◽  
Perinatal Mortality ◽  
Perinatal Death ◽  
Developed Countries ◽  
Perinatal Deaths ◽  
Neonatal Deaths ◽  
Normal Birth ◽  
Perinatal Mortality Rate ◽  
Still Births ◽  
Early Neonatal Deaths

Abstract: Perinatal death is a big problem especially in a developing country. Some of the hospitals in Indonesia have declared that the number of perinatal death in developing countries is higher than in  developed countries. The purpose of this research is to determine the incidence of the factors that affecting perinatal mortality at Prof. DR. R. D. Kandou General Hospital Manado. This research used retrospective descriptive method through medical records of perinatal deaths patients. There were 164 cases of perinatal deaths found where 109 cases still births and 55 cases were early neonatal deaths in 2011, so the number of perinatal mortality rate was 40.17 per mil. The highest number of perinatal death was from multigravide mother, mother with age  ≥ 35 years old, spontaneous parturition. There were unknown caused of still births cases (77,06%) and sepsis in early neonatal deaths. The normal birth weight is also with most include of perinatal deaths. Keywords: still birth, early neonatal death, perinatal deaths, perinatal mortality rate.     Abstrak: Kematian perinatal merupakan masalah besar khususnya di negara sedang berkembang. Beberapa rumah sakit pendidikan di Indonesia melaporkan angka kematian perinatal yang tinggi dibandingkan dengan laporan angka kematian perinatal di negara – negara maju yang jumlahnya rendah. Tujuan penelitian untuk mengetahui angka kejadian kematian perinatal serta faktor – faktor yang mempengaruhinya. Penelitian ini menggunakan metode deskriptif retrospektif dengan menggunakan data catatan medik pasien. Hasil penelitian yaitu jumlah kematian perinatal pada tahun 2011 sebanyak 164 kasus dengan 109 kasus lahir mati dan 55 kasus kematian neonatal dini sehingga angka kematian perinatal pada tahun 2011 yaitu 40.17 per mil. Kematian perinatal paling banyak pada ibu multigravida, ibu dengan kelompok usia ≥ 35 tahun, menggunakan jenis persalinan spontan. Pada lahir mati 77.06 % penyebab kematiannya tidak diketahui sedangkan sepsis paling banyak menyebabkan kematian neonatal dini. Berat badan lahir normal juga menjadi salah satu faktor terjadinya kematian perinatal. Kata kunci: lahir mati, kematian neonatal dini, kematian perinatal, angka kematian perinatal.

Study of obstetric factors in perinatal morbidity and mortality at a tertiary centre

2017 ◽  
Vol 7 (1) ◽  
pp. 198
Author(s):  
Sanjaykumar G. Tambe ◽  
Yogesh A. Thawal ◽  
Tania Anand ◽  
Dipak Suresh Kolate
Keyword(s):  
Perinatal Mortality ◽  
Health Care Providers ◽  
Perinatal Death ◽  
Golden Rule ◽  
Vital Statistics ◽  
Safe Motherhood ◽  
Care Providers ◽  
Perinatal Deaths ◽  
Neonatal Deaths ◽  
Tertiary Center

Background: Safe motherhood and child survival have always been a concern for the policymakers but perinatal mortality, especially stillbirths, have not received due attention. There are 5.9 million perinatal deaths worldwide, almost all of which occur in developing countries. Stillbirths account for over half of all perinatal deaths. This study was aimed to determine perinatal mortality rate and related obstetrics risk factors. Perinatal mortality is only a tip of the iceberg, morbidity being much higher. Vital statistics obtained through this study may serve an important source of information to guide the public health policy makers and health care providers in future.Methods: Present observational study was undertaken in a tertiary center to look into various maternal factors and possible cause of perinatal death. All perinatal deaths including stillbirths (SBs) and early neonatal deaths (ENNDs) within 0-7 days of birth after 28 weeks of gestation were analysed. The data was collected through a pre-designed proforma.Results: Perinatal mortality is 66.27/1000 births in our centre, where 37% were intrauterine deaths, 34% were neonatal deaths and 29% were still births. Preterm, pregnancy induced hypertension; abruptio placentae remain the most important factors for perinatal loss.Conclusions: One of the reasons for high perinatal mortality in tertiary centres is because of poor antenatal care at peripheral centres and late referrals. Early detection of obstetric complications and aggressive treatment is one of golden rule to reduce perinatal loss.

The Present and Future of Psychiatric Diagnosis

2017 ◽  
Author(s):  
Steven E. Hyman
Keyword(s):  
Mental Disorders ◽  
Mental Disorder ◽  
Signs And Symptoms ◽  
International Classification Of Diseases ◽  
Diagnostic Classification ◽  
Statistical Manual ◽  
Classification Schemes ◽  
Diagnostic And Statistical Manual ◽  
Classification Of Diseases

Psychiatric disorders are currently diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders and the closely related International Classification of Diseases. Both diagnostic classification schemes are descriptive and based on a collection of signs and symptoms associated with a given disorder. The fundamental weakness of the schemes is that they are not based on the underlying genetic or neurobiological etiology or pathophysiology of a disorder which of course remain unknown for all common psychiatric syndromes. As more is learned about the biological basis of a mental disorder it will be possibly increasingly to build more accurate diagnostic schemes with greater prognostic and treatment validity.

scholarly journals Death surveillance and contributions to an improved definition of the underlying cause of neonatal death

2021 ◽  
Vol 10 (13) ◽  
pp. e571101321391
Author(s):  
Dayane da Rocha Pimentel ◽  
Rosário Antunes Fonseca Lima ◽  
Mirian Domingos Cardoso ◽  
Conceição Maria de Oliveira ◽  
Cristine Vieira do Bonfim
Keyword(s):  
International Classification Of Diseases ◽  
Kappa Index ◽  
Neonatal Deaths ◽  
Confidential Data ◽  
Before And After ◽  
Classification Of Diseases ◽  
Underlying Causes ◽  
Underlying Cause Of Death ◽  
Definition Of

Objective: To analyze the improvement of the definition of the underlying cause of neonatal deaths before and after death surveillance in Recife, Pernambuco. Methods: A descriptive study that used data from medical certificates of death, confidential data sheets, summaries of investigations. The profiles and the relocation of the underlying cause of death were compared before and after the investigation through specific chapters and groups of the Tenth Revision of the International Classification of Diseases. The agreement was analyzed using the Kappa index. Results: Of the total 144 deaths investigated, 95 (66.0%) had their underlying cause redefined. During the general analysis of the neonatal component, a reasonable agreement index was identified (0.311; CI95%: 0.272-0.350). All ill-defined causes were clarified after surveillance. There was an increment of the preventability potential for all neonatal deaths, with an emphasis on early deaths, which reached 100% causes registered as preventable. Conclusion: Death surveillance made it possible to improve the specificity of the underlying causes described in the medical certificate of death and may contribute to the reorientation of the strategies to reduce neonatal mortality from the perspective of preventability.

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