Bogdanović Milenko D, Marić Gorica D, Pekmezović Tatjana D, Alempijević Đorđe M
Institute of Forensic Medicine "Milovan Milovanović", School of Medicine, University of Belgrade, Belgrade, Serbia.
Institute of Epidemiology, School of Medicine, University of Belgrade, Belgrade, Serbia.
J Forensic Leg Med. 2019 Feb;62:34-39. doi: 10.1016/j.jflm.2018.12.009. Epub 2019 Jan 4.
One of the most frequently used indicators for the quality of mortality statistics is the use of R-codes as the cause of death (COD) in death certificates. The aim of this study was to analyse the coding of ill-defined and unknown causes of death in the Republic of Serbia (RS). The data for this descriptive study, covering a ten-year period (2006-2015), were obtained from the National Mortality Register. Since population and economic features differ widely between regions in RS, we compared the Belgrade region (BR) with other regions (Or). We estimated the frequency of certain types of death investigation methods regarding R00-99-coded deaths. The frequency of R-codes, by subcategories, and code-specific mortality rates were calculated by region for each year. The use of R-codes was significantly lower in BR than in Or (OR 0.85; 95% CI, 0.84-0.66; p < 0.001). The most frequent method of determining COD was external examination of the body, both in BR and Or (60.7% and 85.5%, respectively). The rate of forensic autopsies in BR was 38.1% while in Or it was only 3.6%. Clinical autopsies were performed in 1% of deaths in BR, compared to 0.5% in Or. Our results suggest that in BR the use of R-codes compared to other CODs has decreased over the past years while there has been an increasing trend in autopsy proportions; in Or the frequency of R-codes, as well as of autopsy proportions, has remained unchanged.
死亡率统计质量最常用的指标之一是在死亡证明中将R编码用作死因（COD）。本研究的目的是分析塞尔维亚共和国（RS）死因定义不明确和不明原因死亡的编码情况。这项描述性研究的数据涵盖了十年期（2006 - 2015年），取自国家死亡率登记册。由于RS各地区的人口和经济特征差异很大，我们将贝尔格莱德地区（BR）与其他地区（Or）进行了比较。我们估计了关于R00 - 99编码死亡的某些类型死亡调查方法的频率。每年按地区计算R编码的频率（按子类别）和特定编码的死亡率。BR中R编码的使用显著低于Or（OR 0.85；95% CI，0.84 - 0.66；p < 0.001）。确定死因最常用的方法是尸体外部检查，在BR和Or中都是如此（分别为60.7%和85.5%）。BR中的法医尸检率为38.1%，而在Or中仅为3.6%。BR中1%的死亡进行了临床尸检，而Or中为0.5%。我们的结果表明，在BR中，与其他死因相比，R编码的使用在过去几年中有所下降，而尸检比例呈上升趋势；在Or中，R编码的频率以及尸检比例均保持不变。
