Abstract

MURATORE, Claudio et al. Accuracy of the Death Certificate (DC) to Assess the Cause of Death and Comparison with the Verbal Autopsy: The PRISMA Study. Rev. argent. cardiol. [online]. 2006, vol.74, n.4, pp.211-216. ISSN 1850-3748.

The data contained in the death certificate (DC) do not accurately reflect the causes and circumstances of death. Objectives 1. To identify the cause of death in 20 cities of Argentina using a Verbal Autopsy System (VAS) and compare them to those stated in the DC; 2. To analyze the risk factors and cardiovascular history related to cardiovascular death. Methods We included all subjects older than 18 years of age who died during the 2 month-enrollment period of 2004, in the 20 participant cities. Results A total of 1274 deaths occurred during the period analyzed. According to the VAS, the most frequent causes of cardiovascular death were; heart failure (23%), stroke (11.3%) and myocardial infarction (8%), while the most common noncardiovascular causes of death were: malignancies (21.5%), pneumonia (7.6%) and infections (6.6%). In 11.7 % of deaths, the cause of death could not be clearly established, according to the DC. Agreement for both methods (CD and VAS) in defining the cause of death was 0.608 (V Cramer), kappa value was 0.614 (0.580-0.647) and the kappa weighted value was 0.596 (0.555-0.637). Compared to VAS, the DC underestimated heart failure in 6.6% of cases and overestimated non-cardiovascular deaths in 8% of cases. Cardiovascular death was significantly associated to the presence of risk factors and a history of cardiovascular disease. Conclusions A high proportion of DC's do not clearly establish the cause of death. The greatest discrepancy between the DC and VAS was related to cardiovascular death due to heart failure and other causes of cardiovascular death.

Keywords : Mortality; Cardiovascular death; Epidemiology; Certificate of Death; Verbal Autopsy System.