Ill-defined causes of death in Brazil: a redistribution method based on the investigation of such causes

França, Elisabeth Barboza; Teixeira, Renato Azeredo; Ishitani, Lenice Harumi; Duncan, Bruce Bartholow; Cortez-Escalante, Juan José; Neto, Otaliba Libânio de Morais; Szwarcwald, Célia Landman

doi:10.1590/s0034-8910.2014048005146

Cited by 79 publications

(121 citation statements)

References 19 publications

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“…Studies based on official mortality statistics always present limitations inherent in the process of obtaining primary information. In the case of Brazil, the historical differences in coverage of the mortality system and the unequal proportion of ill-defined causes of death are limiting factors that have recently been corrected with the improvement of the entire system 31 . If corrections did not capture real regional differences, they could distort relative trends between regions.…”

Section: Discussionmentioning

confidence: 99%

Doença cerebrovascular no Brasil de 1990 a 2015: Global Burden of Disease 2015

Lotufo

Goulart

Passos

et al. 2017

Rev. bras. epidemiol.

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The risk of death has been halved across the country, but states in the lower SDI tertile had less significant reductions (-1.23 and -1.84% a year) compared to the middle tertile (-1.94 and -2.22%) and the upper tertile (-2.85 and -2.82%) for men and women, respectively. The years lived with disability also presented a reduction among states, but less expressively. Conclusion: Despite the reduction of age-adjusted mortality rates throughout the country, cerebrovascular disease still presents a high disease burden, especially in states with lower socioeconomic development.

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Section: Discussionmentioning

confidence: 99%

Doença cerebrovascular no Brasil de 1990 a 2015: Global Burden of Disease 2015

Lotufo

Goulart

Passos

et al. 2017

Rev. bras. epidemiol.

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“…The high proportion of ill-defined causes and the lack of stroke subtypes classification of Brazilian death certificates are markers of low data quality, usually related to the access or the quality of medical care received by the population 11 . Besides educational strategies and advocacy among doctors aiming the description of stroke subtype on death certificates, it is essential to provide referral hospitals with adequate diagnosis equipment, mainly in less developed regions.…”

Section: Discussionmentioning

confidence: 99%

“…The crude number of notified deaths were corrected according to the following steps: 1) deaths with non-registered sex or age were reallocated pro-rata according to registered sex and age; 2) redistribution of garbage codes, that is, deaths from all other ICD chapters assigned to causes that cannot or should not be considered underlying causes of death, by sex and region 1 and 3) redistribution of ill-defined causes of deaths (ICD 10 XVIII chapter) 11 (Table 1). Finally, as considerable differences exist in the degree of completeness of the vital registration among the Brazilian regions, the proportion of all deaths that is registered for the population covered by the vital registration system has been estimated separately.…”

Section: Methodsmentioning

confidence: 99%

Consistent declining trends in stroke mortality in Brazil: mission accomplished?

Passos

Ishitani

Franco

et al. 2016

Arq. Neuro-Psiquiatr.

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Stroke is the second leading cause of death in Brazil and worldwide 1 and trends in stroke mortality rates may be analyzed as a proxy of social economic differences among countries and regions. A systematic review of population-based studies showed a divergent, statistically significant difference trend in stroke incidence rates, from 1970 to 2008. It was observed a 42% decrease in stroke incidence in high income countries in contrast to a more than 100% increase in this incidence in middle and low income countries 2 . There is a ten-fold difference in mortality rates for stroke between the most-affected and the less-affected countries. Moreover, national per capita income has been pointed out as the strongest predictor of stroke mortality even after adjusting for cardiovascular risk factors 3 . In Brazil, there is evidence of declining mortality from stroke in São Paulo since the 1970s 4 and all over the country since the 1980s 5 , but the magnitude of the mortality rates and its decline, as well as the differences among the regions of the country need to be better investigated. From 1979 to 1996, among Brazilian adults aged 30 or more years old, despite the high values, the age-adjusted death rate for stroke dropped significantly (p<0.001) from 200 to 164 deaths/100,000 population in men and from 168 to 130 deaths/100,000 population in women ABstrACtStroke mortality rates are declining in Brazil, but diferences among regions need to be better investigated. The age-adjusted stroke mortality trends among adults (30-69 years-old) from Brazilian regions were studied between 1996 and 2011. Method: Data were analyzed after: 1) reallocation of deaths with non-registered sex or age; 2) redistribution of garbage codes and 3) underreporting correction. A linear regression model with autoregressive errors and a state space model were fitted to the data, aiming the estimation of annual trends at every point in time. Results: Although there were high values, a steady decrease of rates was observed. The decreasing trends among all regions were statistically significant, with higher values of decline among the Northeast and Northern regions, where rates were the highest. Conclusion: Standardized methodology use is mandatory for correct interpretation of mortality estimates. Although declining, rates are still extremely high and efforts must be made towards prevention of stroke incidence, reduction of case-fatality rates and prevention of sequelae.Key-words: stroke; mortality rate; health inequalities. resumo Objetivos: As taxas de mortalidade por acidente vascular encefálico (AVE) estão em declínio no Brasil, mas diferenças entre as regiões precisam ser melhor investigadas. Foram analisadas as tendências de mortalidade por AVE ajustadas por idade em adultos (30-69 anos) de regiões do Brasil, entre 1996 e 2011. Método: Análise realizada após realocação dos óbitos sem registro de sexo ou idade; redistribuição de códigos mal definidos e correção do subregistro. Modelos de regressão linear e de espaço de estados foram utilizad...

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“…Quality of death information is classified as medium [19], with considerable heterogeneity across regions [20,21]. Ill-defined causes are still high where the quality of information is low, and a significant proportion of cervical cancer cases are coded as 'uterus, part unspecified' [6,[20][21][22][23]. Furthermore, official reports take in consideration only deaths coded as 'cervix uteri' [5].…”

Section: Introductionmentioning

confidence: 99%