Penttilä A, Ahonen A
Forensic Sci Int. 1979 May-Jun;13(3):221-37. doi: 10.1016/0379-0738(79)90290-1.
An international comparison of mortality rates in middle-aged men (35--54 years) from cardiovascular diseases (CVD) during the period 1970--1974 was made. The material for this study was obtained from the statistics of the WHO (World Health Statist. Ann. 1970--1974, Vol. I, Vital Statistics of Causes of Death. WHO, Geneva, 1973--1976). The mean death rate of middle-aged men from all CVD and ischaemic heart diseases was clearly higher in Finland than in any other country in the world during the 5-year period. The mortality rates according to all ICD (International Classification of Diseases) main groups of diseases were determined for a selected group of countries containing all the Scandinavian countries, the United States, Canada, Hungary, Australia, Scotland, and Czechoslovakia. The death rates of all natural (ICSI-XVI) and unnatural causes (ICDXVII) were higher in Finland than in the other selected countries. Also the proportion of cardiovascular deaths as a percentage of all natural deaths was clearly higher in Finland than in any of the above countries, whereas in these countries proportionally more deaths were due to neoplasms than in Finland, especially in men aged 35--44. Only in Hungary did infectious diseases account for about 4.5% of all natural deaths; in the other countries they accounted for only about 1--2%. In the United States, Sweden, Czechoslovakia and Canada a clearly higher relative number of deaths (about 9--13%) were due to diseases of the digestive system than in the other countries (about 3--9%), whereas the relative numbers of deaths from respiratory and genitourinary diseases were uniform among all selected countries. Only in Denmark and Norway was a prominent proportion of the deceased (3.5--9.5%) certified as having died due to some symptom or ill-defined condition. About 90% of all middle-aged men died in each country from various diseases of the above six main ICD categories. As a whole, the above single deviations from the general trend were so small that the present results do not support the view that the differences in certifying and coding practices could explain the significant differences found in cardiovascular mortality of middle-aged men between various countries.
对1970年至1974年期间中年男性（35 - 54岁）心血管疾病（CVD）死亡率进行了国际比较。本研究的资料取自世界卫生组织的统计数据（《世界卫生统计年鉴》，1970 - 1974年，第一卷，死因统计。世界卫生组织，日内瓦，1973 - 1976年）。在这5年期间，芬兰中年男性因所有心血管疾病和缺血性心脏病的平均死亡率明显高于世界上任何其他国家。针对一组选定的国家确定了所有国际疾病分类（ICD）主要疾病组的死亡率，这些国家包括所有斯堪的纳维亚国家、美国、加拿大、匈牙利、澳大利亚、苏格兰和捷克斯洛伐克。芬兰所有自然原因（ICD I - XVI）和非自然原因（ICD XVII）的死亡率均高于其他选定国家。芬兰心血管死亡占所有自然死亡的百分比也明显高于上述任何国家，而在这些国家，因肿瘤导致的死亡比例比芬兰更高，尤其是在35 - 44岁的男性中。只有匈牙利传染病占所有自然死亡的约4.5%；在其他国家，它们仅占约1 - 2%。在美国、瑞典、捷克斯洛伐克和加拿大，消化系统疾病导致的死亡相对比例（约9 - 13%）明显高于其他国家（约3 - 9%），而所有选定国家中呼吸系统和泌尿生殖系统疾病的死亡相对比例较为一致。只有在丹麦和挪威，相当比例的死者（3.5 - 9.5%）被证明死于某些症状或定义不明确的病症。在每个国家，约90%的中年男性死于上述六个主要ICD类别中的各种疾病。总体而言，上述与总体趋势的个别偏差非常小，以至于目前的结果不支持这样一种观点，即认证和编码做法的差异可以解释不同国家中年男性心血管死亡率存在的显著差异。
