Validación de "infarto de miocardio" como causa de muerte en certificados de defunción, Barquisimeto, Estado Lara, Venezuela

Abstract

Death rates due to Ischemic Heart Disease (IHD) are widely used to assess regional and national cardiovascular health status. However, their validity is questionable, essentially because they are based on death certificates (DCs). The present study was conducted in the Greater Metropolitan Area of Barquisimeto (Lara State, Venezuela), from June 1991 to July 1992. The purpose was to establish the validity of the diagnosis of myocardial infarction in DCs of intrahospital deaths. Efforts were made to locate all clinical charts and any other relevant information. To validate the diagnosis of MI in the DC we used the MONICA project criteria. During the study period a total of 247 eligible DCs were recorded. Sufficient clinical information was located for 136 cases (55%). The results were as follows: definite MI - 62 cases (45.6%); probable MI - 31 cases (22.8%); and non MI - 43 cases (31.6%). These results may indicate an overestimation of MI death rates of about 32% [95% Confidence Interval = 23.8% - 39.4%]. Since these data are from a region with an organized cardiovascular health system, it is expected that the overestimation for the rest of the country may be even higher. Thus, in order to enhance quality and accuracy of DCs, it is necessary to develop a system to improve adherence to existing norms for filling out and processing such forms.

Enhancing global capacity in the surveillance, prevention, and control of chronic diseases: seven themes to consider and build upon

“…A study in Venezuela, for example, found that about one-third of the death certificates listing myocardial infarction as a cause of death were in error according to WHO MONICA case definitions 48. Because questionnaires are so important in collecting health information, a catalogue of biases in questionnaires is now available 49…”