2015-2018年乌海市市区居民死因分析

目的 了解2015-2018年乌海市市区居民主要死因及寿命损失，为提出有针对性的疾病预防控制策略提供依据。 方法 整理2015-2018年乌海市市区居民全死因数据，分析死亡率、死因顺位、期望寿命等指标。结果 2015-2018年乌海市市区居民粗死亡率为533.59/10万，标化死亡率为531.61/10万，男性高于女性，随年龄增长死亡率呈升高趋势（〖XC小五号.EPS;P〗=30785.35，P<0.001）。全人群死因前5位依次为循环系统疾病、肿瘤、呼吸系统疾病、损伤和中毒及其他，占全部死亡人数的90.34%；其中循环系统疾病和肿瘤占全部死亡人数的69.33%。2015-2018年乌海市市区居民期望寿命为77.20岁，去循环系统疾病和去肿瘤后期望寿命可分别增加5.44岁和3.33岁。结论 循环系统疾病和肿瘤是乌海市市区居民的两大死因，也是造成居民期望寿命损失最主要的两大疾病，尤其要重点关注肿瘤。     

湖北谷城县2009-2013年居民死因监测

目的分析湖北谷城县2009-2013年居民死亡率、死亡趋势、死因谱,掌握主要危害居民健康的主要疾病谱和变化趋势,为全县卫生政策制定和资源配置提供科学依据。方法收集谷城县2009-2013年死因监测资料,按ICD-10国际疾病分类对死因进行分类及编码,对死因进行统计分析,计算人群粗死亡率、死因构成、死因顺位等指标。结果谷城县2009-2013年居民年平均粗死亡率为683.77/10万,其中男性为850.32/10万,女性为512.23/10万,男：女为1.71∶1;全人群前5位死因依次为循环系统疾病、肿瘤、呼吸系统疾病、损伤与中毒、消化系统疾病,占全死因95.75%;0-14岁组、15-39岁组主要死因均为损伤与中毒分别占35.59%,58.53%;40-64岁组、65岁以上组主要死因均为循环系统疾病分别占38.36%,42.87%;死因顺位第一循环系统疾病中,以脑血管疾病为主,死亡率196.92/10万;其次为心血管疾病死亡率118.78/10万。肿瘤死亡主要肺癌死亡率42.69/10万,占26.37%;其次肝癌死亡率29.78/10万,占18.40%。呼吸系统疾病主要死因为慢性下呼吸道疾病,死亡率52.21/10万,占全死因的7.63%;损伤与中毒死亡中机动车辆交通事故占29.33%,自杀占18.77%,淹死占9.92%。结论循环系统疾病、肿瘤、呼吸系统疾病等一些慢性非传染性疾病、意外和中毒是谷城县的主要死亡原因。     

湖南省疾病监测点2006-2008年居民死因监测结果分析

目的 了解2006-2008年湖南省城乡居民疾伤死因. 方法 资料采用国际疾病分类ICD-10进行编码并录入死因统计软件DeathReg2005进行统计分析. 结果三年累计监测人口数为12 235 014人,居民疾伤总死亡75 607例,平均死亡率为617.96/10万,其中男性居民死亡率719.56/10万,女性居民509.33/10万,两者差异有统计学意义(P＜0.01);农村的死亡率633.43/10万高于城市居民575.71/10万(P＜0.01);循环系统疾病为居民第1位死因,其次是肿瘤、呼吸系统疾病. 结论循环系统、呼吸系统、肿瘤为居民死亡的主要原因,应积极防治,减少居民死亡.     

2006-2009年大连市金州区居民死因分析

目的了解金州区居民的健康水平及其影响因素,为针对影响居民健康状况的主要死因进行干预提供科学依据。方法使用卫生部指定的死因专用软件"DeathReg2005"对"中国疾病预防控制系统"的"死因登记报告信息系统"中的数据进行统计分析,按照国际疾病分类ICD-10进行分类统计。结果 2006-2009年金州区居民年均死亡率为749.92/10万,标化死亡率为406.17/10万;前5位死因依次是循环系统疾病、肿瘤、损伤中毒、呼吸系统疾病、内分泌系统疾病;各年龄组主要死因婴儿组为围生期疾病、少儿组为损伤中毒、青中年为肿瘤、老年人为循环系统疾病;对寿命损失影响最大的前3位死因是肿瘤、损伤中毒、循环系统疾病。结论循环系统疾病、肿瘤等慢性非传染性疾病和伤害已成为金州区居民的主要死因。     

南昌市安义县2004～2009年居民死因分析

目的了解南昌市安义县居民的死亡水平、死亡的变化趋势以及死因模式的变化,为疾病的预防与控制提供决策依据。方法采用国际疾病分类ICD-10对死因资料进行编码,应用SPSS13.0软件进行相关统计指标分析。结果2004～2009年安义县居民年均粗死亡率为467.63/10万,标化死亡率为498.52/10万,呈逐年下降趋势。男性标化死亡率(555.82/10万)高于女性(434.67/10万)(χ2=109.511,P=0.000);0～14岁、15～64岁、65岁及以上组年均死亡率分别为53.83/10万,207.11/10万、4 535.71/10万;前5位的主要死因为循环系统疾病、肿瘤、损伤和中毒、呼吸系统疾病以及消化系统疾病。6年年均期望寿命为76.79岁,其中男性74.44岁,女性80.68岁。对居民寿命影响最大的死因为循环系统疾病,去除该死因后,期望寿命可提高5.90岁,增长7.68%。结论慢性病尤其是循环系统疾病及肿瘤是今后预防控制的重点,男性的健康问题应引起社会的广泛关注和重视。     

2014-2019年重庆市沙坪坝区死因谱变化趋势分析

目的了解沙坪坝区2014-2019年死因谱变化趋势,为制定辖区疾病防控策略和措施提供科学依据。方法收集整理国家死因监测系统中的死亡数据。结果 2014-2019年全人群及女性标化死亡率呈下降趋势(F=10.17,8.54,P0.05),APC分别为-5.26%、-4.69%。历年男性标化死亡率均高于女性,死亡性别比为1.40∶1。不同年龄组死亡率随年龄增长呈“√”形增高。历年前5位死因均依次为循环系统疾病、肿瘤、呼吸系统疾病、损伤与中毒以及内分泌、营养和代谢疾病。前5位死因合计死亡占比为91.35%。损伤和中毒标化死亡率均呈下降趋势(P0.01),APC为-10.33%。结论循环系统疾病、肿瘤、呼吸系统疾病等慢性病已成为辖区居民第一大杀手。应以慢性病防控为重点,大力开展健康生活方式干预,整体提高辖区居民健康水平。     

2008～2012年贵州省疾病监测点居民主要死亡原因及趋势分析

目的:了解贵州省全国疾病监测点居民死亡原因及其变化趋势,为疾病预防控制提供科学依据。方法:对2008~2012年贵州省全国疾病监测点居民死因监测数据用spss19软件进行数据统计、分析。结果:5年贵州省疾病监测点居民共计死亡40837例,平均死亡率为531.48/10万,标化死亡率为471.25/10万,男性高于女性。居民前5位死因依次为循环系统疾病、呼吸系统疾病、肿瘤、伤害和消化系统疾病。不同年龄主要死亡疾病有所不同。5年来,循环系统疾病所占比例逐年增加,传染病、寄生虫病及围生期疾病死亡所占比例呈下降趋势,伤害死亡所占比例总体呈下降趋势。结论:循环系统疾病、呼吸系统疾病、肿瘤等慢性非传染性疾病及意外伤害死亡已成为贵州省疾病监测点主要死因。     

大理州祥云县2008-2012年死因监测结果分析

[目的]分析大理州祥云县2008-2012年居民死亡率、死亡趋势、死因谱,掌握主要危害居民健康的主要疾病谱和变化趋势,为全州卫生政策制定和资源配置提供科学依据。[方法]收集2008-2012年祥云县居民死因监测资料,按 ICD-10国际疾病分类对死因进行分类及编码,运用 Excel2003和 SPSS 17.0进行统计分析,计算人群粗死亡率、死因构成、死因顺位和潜在减寿年数等指标。[结果]2008-2012年祥云县居民年平均粗死亡率为609.9/10万,其中男性为703.6/10万,女性为513.2/10万,男：女为1.41：1;全人群前5位死因依次为循环系统疾病、呼吸系统疾病、损伤和中毒、肿瘤、消化系统疾病,共占85.5%;0～1岁组主要致死原因的首位是围产期疾病（占52.9%）;1～14岁组的主要死因是意外与中毒（占61.81%）;15～64岁组主要以循环系统疾病、损伤与中毒为主（占51.5%）;65岁以上组主要以呼吸系统疾病为主（占40.98%）;损伤和中毒在减寿顺位中和平均减寿顺位中居首位。[结论]起源于围生期的某些疾病、损伤和中毒、慢性病是居民的主要死亡原因。提示在育龄妇女应加强婚前检查及产检,预防婴幼儿围生期疾病,在儿童青年应着重加强损伤和中毒的预防,在中老年人应加强呼吸系统疾病、循环系统疾病、肿瘤等慢性病的防治。     

江苏省扬中市2002-2013年居民死因及减寿分析

目的了解扬中市居民死因特征,为相关疾病防治提供依据。方法采用国际疾病分类标准进行编码分类,应用死亡率、标化率、死因顺位、潜在减寿年数(PYLL)等指标,对扬中市死因监测资料进行描述性分析。结果 2002-2013年扬中市居民死亡率为72.75/10万、标化死亡率为437.05/10万,粗死亡率呈上升趋势(P=0.04)、标化死亡率呈下降趋势(P=0.002)。前5位死因依次是恶性肿瘤(40.50%)、循环系统疾病(31.40%)、呼吸系统疾病(8.88%)、损伤和中毒(5.51%)和其他类疾病(4.58%)。其中恶性肿瘤、其他类疾病标化死亡率呈下降趋势(P<0.05),循环系统疾病、呼吸系统疾病、损伤和中毒无明显升降趋势(P>0.05);PYLL前5位为恶性肿瘤、损伤和中毒、循环系统疾病、呼吸系统疾病和消化系统疾病。结论恶性肿瘤、循环系统疾病、呼吸系统疾病是扬中市居民的主要死因,对人群生存时间和工作时间的损失也最大,是今后防治工作的重点。     

鲁山县1990～2001年居民死亡原因动态分析

目的了解我市山区居民的死亡水平和死因谱变动情况。方法收集鲁山县1990～2001年历年人口数和死亡个案,输入计算机进行统计处理,死因分类采用ICD-9的标准和要求。结果1990～2001年鲁山县居民的死亡率和死因构成以循环系统疾病、肿瘤、损伤和中毒、呼吸系统疾病、消化系统疾病、感染性疾病居前六位;男性死亡率高于女性(x2=46.12,p<0.01);各年龄组死亡率与死因不同,婴儿以新生儿最多占65.98%,少年儿童死亡以损伤和中毒(47.19%)、感染性疾病(14.43%)、呼吸系病(13.05%),青壮年死亡以损伤中毒、肿瘤和循环系统疾病最多;老年人群死亡则以循环系统疾病、呼吸系统疾病、肿瘤为主。结论循环系统疾病、肿瘤、损伤和中毒、呼吸系统疾病是危害居民健康和生命的主要疾病,加强慢性非传染性疾病的防治工作,是今后疾病控制工作的重点。     

A medical cause of death validation study of adult Aboriginal deaths in the Northern Territory of Australia in 1992

Judged on the criterion of equity, premature adult Aboriginal mortality is the most serious public health problem faced in Australia today. There have been a number of published epidemiological studies that have analysed Aboriginal cause of death data, but this is the first study to formally validate such data. The study sample included all adult Aboriginal people who lived and died in the Northern Territory in 1992, excluding residents of the Alice Springs region. The appropriateness of underlying cause of death codes was assessed by a single reviewer in light of death certificates, medical records, postmortem records and interviews with key health professional informants. Data were collected on 220 deaths. 8% (17 out of 220) of deaths were classified erroneously at the ICD-9 chapter level. Errors in death certification accounted for 64% (11 out of 17) of the chapter errors and diagnostic and coding errors for 18% (3 out of 17) each. The overall impact on mortality statistics was less severe because some cross-chapter classification errors cancelled each other out. Misclassification errors aggregated mainly in chapter VII (circulatory diseases) of the ICD-9 classification which was overcounted by 3.2%, and chapter VIII (respiratory diseases) which was overcounted by 1.3%. Before correction for misclassification error, circulatory diseases were judged to cause the highest proportion of deaths, whereas after correction, respiratory diseases accounted for the highest proportion. Despite this, the overall quality of the medical cause of death statistics was of a sufficiently good standard from a public health perspective to broadly inform health policy. Future attempts to improve the validity of medical cause of death statistics for Australian Aboriginal people should focus on the education of medical practitioners about the purpose and process of death certification.     

Compiling mortality statistics from civil registration systems in Viet Nam: the long road ahead

Accurate mortality statistics, needed for population health assessment, health policy and research, are best derived from data in vital registration systems. However, mortality statistics from vital registration systems are not available for several countries including Viet Nam. We used a mixed methods case study approach to assess vital registration operations in 2006 in three provinces in Viet Nam (Hòa Bình, Thùa Thiên–Hué and Bình Duong), and provide recommendations to strengthen vital registration systems in the country. For each province we developed life tables from population and mortality data compiled by sex and age group. Demographic methods were used to estimate completeness of death registration as an indicator of vital registration performance. Qualitative methods (document review, key informant interviews and focus group discussions) were used to assess administrative, technical and societal aspects of vital registration systems. Completeness of death registration was low in all three provinces. Problems were identified with the legal framework for registration of early neonatal deaths and deaths of temporary residents or migrants. The system does not conform to international standards for reporting cause of death or for recording detailed statistics by age, sex and cause of death. Capacity-building along with an intersectoral coordination committee involving the Ministries of Justice and Health and the General Statistics Office would improve the vital registration system, especially with regard to procedures for death registration. There appears to be strong political support for sentinel surveillance systems to generate reliable mortality statistics in Viet Nam.     

A comparison of underlying cause and multiple causes of death: US vital statistics, 2000-2001

BACKGROUND: Mortality statistics can be compiled using underlying cause-of-death data or multiple cause-of-death data, which include other contributing causes of death. METHODS: For the leading causes of death in the United States during 2000-2001, we compared underlying and multiple cause-of-death statistics. RESULTS: For some conditions, little difference was observed between the 2 estimates. For other conditions, up to 10 times more deaths were identified from multiple-cause data than from underlying-cause data. The 10 leading causes of death differed when using the 2 types of data. CONCLUSIONS: Whenever possible, underlying and multiple cause-of-death statistics should both be presented. Analyses that use only the underlying cause of death ignore additional information that is readily available from multiple-cause data, and the more limited data may underestimate the importance of several leading causes of death.     

Comparability between ICD-9 and ICD-10 for the leading causes of death in Spain

BACKGROUND: Implementation of a new Revision of the International Classification of Diseases can create discontinuity in mortality statistics. Revisions are nevertheless essential to ensure international comparability of health statistics. The purpose of this work was to describe the effects of the 10th Revision on mortality statistics by sex and age for leading causes of death in Spain. METHODS: A cross-sectional study of leading causes of death was carried out when the underlying cause of death was coded using both the 9th and 10th Revisions of the International Classification of Diseases in 88,044 death certificates completed in five Autonomous Communities of Spain (Andalusia, Cantabria, Murcia, Navarra, the Basque Country), and the city of Barcelona during the year 1999. Changes introduced by the 10th Revision were described by simple correspondence, percentage of change, Kappa index and comparability ratios between the 10th and the 9th Revision along with their 95% confidence intervals by sex and five-year age group, for the leading causes of death. RESULTS: Under the 10th Revision, AIDS deaths rose by 3.6% (comparability ratio (CR): 1.036; 95% confidence interval (CI):1.015-1.058), arteriosclerosis by 7.1% (CR: 1.071; 95% CI: 1.052-1.090), and drug overdose by 5.2% (CR: 1.052; 95% CI: 0.964-1.140). Mortality due to vascular and senile dementia and non specific dementia declined by 3.2% under the 10th (CR: 0.969; 95% CI: 0.950-0.988). In all the other causes of death the percentage of change regardless of direction was less than 2%. CONCLUSION: The present study found good agreement between ICD-9 and ICD-10 on the leading causes of death and premature mortality in Spain. Causes of death which present differences between Revisions were AIDS, arteriosclerosis, drug overdose and senile dementia. For these causes, the comparability ratios must be taken into account when interpreting mortality statistics.     

New dimensions in cause of death statistics.

This article discusses the limitations of traditional national cause of death statistics. These limitations derive from an attempt to conceptualize a multidimensional phenomenon and reduce down to a unidimensional framework. The article outlines the characteristics of a new multidimensional approach which involves the codification and tabulation of all causes (multiple causes) listed on death certificates. Preliminary data are presented which illustrate that multiple cause of death data do indeed represent a major new dimension to cause of death statistics. These data indicate that most major causes of death are contributory factors in many deaths in which they are not the underlying cause of death. For example, in 1976, diabetes mellitus was the underlying cause of approximately 35,000 deaths but was a contributing factor in another 100,000 deaths. This paper also demonstrates the contribution of multiple cause of death data to identifying patterns of association among diseases and the kinds of injuries resulting from various external causes. Finally, data are presented which depict the use of multiple cause data in evaluating the efficacy of the coding rules used to classify the underlying cause of death.     

An assessment of the incidence of maternal mortality in the United States.

Recent studies in several states have found that the incidence of maternal mortality is higher than traditional vital statistics reports indicate. Since no comprehensive national study has been done to evaluate the completeness of maternal mortality ascertainment through the national vital statistics reporting system, the Centers for Disease Control (CDC) undertook such a study with the assistance of the National Center for Health Statistics and state health departments. The state health departments provided CDC with death certificates for all pregnancy-related deaths occurring during 1974-78. We reviewed and classified these certificates using both International Classification of Diseases, Adapted, Eighth Revision (ICDA-8) and International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) maternal death codes. We found that the actual incidence of maternal mortality for 1974-78 was approximately 20 per cent and 30 per cent greater than that published in national vital statistics reports using ICDA-8 and ICD-9-CM, respectively.     

Comparability of cause of death between ICD-9 and ICD-10: preliminary estimates.

OBJECTIVES: This report presents preliminary results describing the effects of implementing the Tenth Revision of the International Classification of Diseases (ICD-10) on mortality statistics for selected causes of death effective with deaths occurring in the United States in 1999. The report also describes major features of the Tenth Revision (ICD-10), including changes from the Ninth Revision (ICD-9) in classification and rules for selecting underlying causes of death. Application of comparability ratios is also discussed. METHODS: The report is based on cause-of-death information from a large sample of 1996 death certificates filed in the 50 States and the District of Columbia. Cause-of-death information in the sample includes underlying cause of death classified by both ICD-9 and ICD-10. Because the data file on which comparability information is derived is incomplete, results are preliminary. RESULTS: Preliminary comparability ratios by cause of death presented in this report indicate the extent of discontinuities in cause-of-death trends from 1998 through 1999 resulting from implementing ICD-10. For some leading causes (e.g., Septicemia, Influenza and pneumonia, Alzheimer's disease, and Nephritis, nephrotic syndrome and nephrosis), the discontinuity in trend is substantial. The ranking of leading causes of death is also substantially affected for some causes of death. CONCLUSIONS: Results of this study, although preliminary, are essential to analyzing trends in mortality between ICD-9 and ICD-10. In particular, the results provide a means for interpreting changes between 1998, which is the last year in which ICD-9 was used, and 1999, the year in which ICD-10 was implemented for mortality in the United States.     

建国前广西生命统计资料再分析

本文根据1937～1942年广西生命统计资料追编了全省人口寿命表,采用ICD-9疾病分类方法分析了主要死亡原因,对解放前我国人口平均期望寿命35岁提出质疑。通过半个世纪人口死亡谱的对照,论证了我国建国以来防治疾病取得的成就与人寿延长的原因。     

Misclassification of childhood homicide on death certificates

Suspect classification of homicide deaths of Connecticut residents under 20 years of age was noted for 29 percent of cases examined. Misclassification was attributed to incomplete or erroneous information recorded on the death certificates, rather than errors in the designation of ICD-9 homicide codes. The results have important implications in the interpretation of vital statistics when homicide is listed as the cause of death and underscore the value of record linkage systems.