Profile of deaths from unspecified stroke after investigation of garbage codes in 60 cities in Brazil, 2017.

Abstract

INTRODUCTION Unspecified stroke (UnST) is of great importance in mortality statistics, as it is the fourth leading cause of death in Brazil. The objective of this study was to identify the profile of reclassified causes of death after investigation of deaths caused by UnST in Brazil. METHODS All deaths registered as UnST in 2017 in the Mortality Information System (SIM) were considered as garbage codes. The specific causes, detected after investigation in 60 selected cities, were analyzed by age and sex. RESULTS Of the total deaths due to UnST identified in these 60 cities (n = 11,289), 25.8% were investigated. Of these, 56.3% were reclassified to ischemic stroke, 12.7% to hemorrhagic stroke, and 23.3% to other specific causes, such as diabetes and chronic kidney disease, in both sexes. DISCUSSION The higher proportion of deaths due to ischemic stroke in comparison to hemorrhagic stroke was expected. However, the detection of other specific causes outside the stroke group indicates possible quality problems in the filling of death certificate (DC). CONCLUSION The investigations allowed the identification of subgroups of deaths due to stroke. In addition to the research, however, it is important to conduct physician training in the adequate filling in of the DC, in order to improve estimates of specific stroke mortality, and to enable appropriate targeting of health actions and services.