Black D A, Jachuck S J
Br Med J (Clin Res Ed). 1984 Apr 14;288(6424):1127-9. doi: 10.1136/bmj.288.6424.1127.
The records of death that had been certified by general practitioners in one practice over 18 years were assessed in the light of the recent joint publications of the Royal College of Physicians and the Royal College of Pathologists. Over this period roughly 30% of the deaths in the practice population occurred outside hospital and a total of 262 certificates were issued. A review of 262 counterfoils of records of death certification showed that 12 counterfoils (4.6%) had no age and sex mentioned, and three counterfoils did not describe the place of death. The average age at death outside hospital was 71.6 years--the age of women being 75.1 years compared with that of men of 68.2 years. Only 2% of patients had had a necropsy. The common causes of death stated in the certificates were: cardiovascular 41%, carcinoma 35%, respiratory 15%, and stroke 8%. All contributory causes are also mentioned. Ninety seven per cent of the patients were seen after death by the doctors in the practice and 68% had been seen in the two days preceding death. We emphasise the importance of keeping accurate records of deaths in general practice for audit and research as well as for planning services for terminally ill and recently bereaved patients.
根据皇家内科医师学院和皇家病理学家学院最近的联合出版物，对一家诊所18年来由全科医生开具的死亡证明记录进行了评估。在此期间，该诊所人群中约30%的死亡发生在医院外，共开具了262份死亡证明。对262份死亡证明记录的存根进行审查后发现，有12份存根（4.6%）未提及年龄和性别，3份存根未注明死亡地点。医院外死亡患者的平均年龄为71.6岁，女性为75.1岁，男性为68.2岁。只有2%的患者进行了尸检。死亡证明中列出的常见死因如下：心血管疾病41%，癌症35%，呼吸系统疾病15%，中风8%。所有促成死因也都有提及。该诊所的医生在患者死亡后对97%的患者进行了查看，68%的患者在死亡前两天内被查看过。我们强调，在全科医疗中准确记录死亡情况对于审计、研究以及为绝症患者和新近丧亲患者规划服务都非常重要。
