Cirera L, Tormo M J, Martínez C, Contreras J, García J, Navarro C
Servicio de Epidemiología, Consejería de Sanidad y Consumo, Región de Murcia, Spain.
Rev Esp Cardiol. 2001 Sep;54(9):1041-7.
This paper aimed to study the usefulness of the Statistical Bulletin of Deaths (SBD) for identifying extrahospital deaths due to acute coronary ischaemia, and to determine the most efficient strategy in the selection of death causes that appear in the SBD, which are the most efficient for the identification.
Those extrahospital deaths, which, among the causes of death, recorded a diagnostic code indicating that they might have been caused by coronary ischaemia, were included. To study the usefulness of the death certificate we calculated the sensitivity and the positive predictive value of cardiac ischaemia. To determine the most efficient strategy for selecting causes of death we compared two selection strategies: the first, using only the basic cause of death; and the second using all the causes appearing in the SBD.
Of the 395 SBD selected, 161 were classed as acute heart attacks. In those SBD in which cardiac ischaemic disease was given as the basic cause of death, we obtained a sensitivity of 82.6% (CI 95%: 75.9-88.1) and a positive predictive value of 72.7% (CI 95%: 65.6-79). The most efficient strategy in SBD selection proved to be the investigation of death certificates in which cardiac ischaemia appeared as one of all the causes of death, and death certificates in which the basic cause of death was coded as diabetes mellitus, essential arterial hypertension, hypertensive heart disease, cardiac dysrhythmia, and cardiac insufficiency.
The information provided by death certificates for extrahospital deaths due to coronary ischaemia is reliable. A sensitive and efficient SBD selection strategy is proposed for the detection of cases.
本文旨在研究《死亡统计公报》（SBD）在识别急性冠状动脉缺血导致的院外死亡方面的实用性，并确定在SBD中出现的死亡原因选择中最有效的策略，这些策略对于识别最为有效。
纳入那些在死亡原因中记录有诊断代码表明可能由冠状动脉缺血引起的院外死亡病例。为研究死亡证明的实用性，我们计算了心脏缺血的敏感性和阳性预测值。为确定选择死亡原因的最有效策略，我们比较了两种选择策略：第一种仅使用根本死因；第二种使用SBD中出现的所有死因。
在所选的395份SBD中，161份被归类为急性心脏病发作。在那些将心脏缺血性疾病列为根本死因的SBD中，我们获得的敏感性为82.6%（95%CI：75.9 - 88.1），阳性预测值为72.7%（95%CI：65.6 - 79）。在SBD选择中最有效的策略被证明是调查那些心脏缺血作为所有死因之一出现的死亡证明，以及那些根本死因被编码为糖尿病、原发性动脉高血压、高血压性心脏病、心律失常和心功能不全的死亡证明。
死亡证明为冠状动脉缺血导致的院外死亡提供的信息是可靠的。提出了一种敏感且有效的SBD选择策略用于病例检测。
