Causes of Death in Patients Asking for Polyclinic Care for Coronary Heart Disease.

IF 0.5 4区 医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Kardiologiya Pub Date : 2024-05-31 DOI:10.18087/cardio.2024.5.n2341
I V Samorodskaya, O V Zayratyants, E P Kakorina, T K Chernyavskaya
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引用次数: 0

Abstract

Aim: Retrospective analysis of the underlying causes for death of patients who did and did not seek outpatient medical care (OPMC) for ischemic heart disease (IHD), and discussion of a possibility for using administrative anonymized but individualized databases for analysis.

Material and methods: The electronic database of the Central Administration of the Civil Registry Office of the Moscow Region (Unified State Register of the Civil Registry Office of the Moscow Region), including medical death certificates (MDC) for 2021, was used to select all cases of fatal outcomes with the disease codes of the International Classification of Diseases, Tenth Revision (ICD-10) (codes of external causes, injuries, poisonings excluded) that were indicated as the primary cause of death (PCD). Personalized data of the deceased were combined with data from electronic medical records of patients who sought OPMC at institutions of the Moscow Region within up to 2 years before death. In addition to IHD, the following PCD codes were taken into account: malignant tumors, COVID-19, diabetes mellitus, cerebrovascular diseases, hypertension, chronic obstructive pulmonary disease, alcohol-associated diseases, and, as examples of unspecified PCD, old age and unspecified encephalopathy.Results In total, among those who died from diseases, the proportion of those who died from IHD was 18.9%; for another 8.4%, IHD was indicated as a comorbid disease in Part II of the MDC. Among those who sought OPMC for IHD, the IHD proportion indicated as PCD was 27.5%, and among those who did not seek OPMC 17.4% (p <0.0001). Those who died from IHD and who had sought OPMC were older (mean age, 75.59 ± 10.94 years) than those who died from IHD and had not sought OMPM (mean age, 73.96 ± 10.94 years; p < 0.0001). The frequency of myocardial infarction as PCD among those who had and had not sought OPMC was the same (12%), chronic forms of IHD were 83.9% and 79.7%, the frequencies of "unspecified" acute forms of IHD (codes I24.8-9) were 4.1% and 8.3%, respectively. The proportion of deaths from COVID-19 was the highest (21.7% and 24.3%, respectively), from malignant neoplasms 11.6% and 12.7%, respectively, and from unspecified encephalopathy 10.6% and 10.7%, respectively.

Conclusion: Only 25% of patients who had sought OPMC for IHD died from IHD, otherwise the causes of death were the same as for patients who had not sought OPMC for IHD. Analysis of administrative databases allows identifying disparities in the PCD structure and to direct the efforts of specialists to reconciling the criteria for death from various forms of IHD.

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要求综合医院治疗冠心病患者的死亡原因。
目的:回顾性分析因缺血性心脏病(IHD)而就诊和未就诊的门诊病人(OPMC)的基本死因,并讨论使用匿名但个性化的行政数据库进行分析的可能性:利用莫斯科地区民事登记处中央管理局(莫斯科地区民事登记处统一国家登记处)的电子数据库(包括 2021 年的医学死亡证明书(MDC)),选择所有以《国际疾病分类》第十次修订版(ICD-10)疾病代码(不包括外因、外伤、中毒代码)作为主要死因(PCD)的死亡病例。死者的个人数据与死亡前两年内在莫斯科地区医疗机构就诊的OPMC患者的电子病历数据相结合。除心肌缺血外,还考虑了以下死因代码:恶性肿瘤、COVID-19、糖尿病、脑血管疾病、高血压、慢性阻塞性肺病、酒精相关疾病,以及作为未指定死因的例子,老年病和未指定脑病。结果 在因疾病而死亡的患者中,死于 IHD 的患者占 18.9%,另有 8.4%的患者在 MDC 第二部分中将 IHD 列为合并疾病。在因患心肌缺血而寻求 OPMC 的患者中,有 27.5%的人的心肌缺血比例显示为 PCD,而在未寻求 OPMC 的患者中,这一比例为 17.4%(p <0.0001)。死于心肌缺血并寻求过 OPMC 的患者(平均年龄为 75.59±10.94 岁)比死于心肌缺血但未寻求过 OMPM 的患者(平均年龄为 73.96±10.94 岁;p <0.0001)年长。在寻求和未寻求 OMPM 的患者中,心肌梗死作为 PCD 的频率相同(12%),慢性形式的 IHD 分别为 83.9% 和 79.7%,"未指定 "急性形式的 IHD(代码 I24.8-9)的频率分别为 4.1% 和 8.3%。死于 COVID-19 的比例最高(分别为 21.7% 和 24.3%),死于恶性肿瘤的比例分别为 11.6% 和 12.7%,死于不明脑病的比例分别为 10.6% 和 10.7%:结论:只有25%曾因心肌缺血而就诊的患者死于心肌缺血,其他患者的死因与未就诊的患者相同。通过对行政数据库的分析,可以发现PCD结构中的差异,并引导专家努力协调各种形式的IHD死亡标准。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Kardiologiya
Kardiologiya 医学-心血管系统
CiteScore
1.70
自引率
20.00%
发文量
94
审稿时长
3-8 weeks
期刊介绍: “Kardiologiya” (Cardiology) is a monthly scientific, peer-reviewed journal committed to both basic cardiovascular medicine and practical aspects of cardiology. As the leader in its field, “Kardiologiya” provides original coverage of recent progress in cardiovascular medicine. We publish state-of-the-art articles integrating clinical and research activities in the fields of basic cardiovascular science and clinical cardiology, with a focus on emerging issues in cardiovascular disease. Our target audience spans a diversity of health care professionals and medical researchers working in cardiovascular medicine and related fields. The principal language of the Journal is Russian, an additional language – English (title, authors’ information, abstract, keywords). “Kardiologiya” is a peer-reviewed scientific journal. All articles are reviewed by scientists, who gained high international prestige in cardiovascular science and clinical cardiology. The Journal is currently cited and indexed in major Abstracting & Indexing databases: Web of Science, Medline and Scopus. The Journal''s primary objectives Contribute to raising the professional level of medical researchers, physicians and academic teachers. Present the results of current research and clinical observations, explore the effectiveness of drug and non-drug treatments of heart disease, inform about new diagnostic techniques; discuss current trends and new advancements in clinical cardiology, contribute to continuing medical education, inform readers about results of Russian and international scientific forums; Further improve the general quality of reviewing and editing of manuscripts submitted for publication; Provide the widest possible dissemination of the published articles, among the global scientific community; Extend distribution and indexing of scientific publications in major Abstracting & Indexing databases.
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