Validación de la causa básica de defunción en las muertes que requieren intervención medicolegal

Abstract

Background: Deaths due to external causes require additio nal medical tests in order to determine the cause of death. If the se results are not incorporated into the death register these cau ses may be misclassified. The objective of this study is to vali date the underlying cause of death of the Mortality Register with information obtained from forensic sources in Barcelona between 2004 and 2006. Methods: Cross-sectional design. The study population consisted of deceased residents in Barcelona with a medicolegal intervention between 2004 and 2006. The sources of informa tion are the Mortality Registry and the forensic pathology file filled in by Institute of Legal Medicine of Catalonia (ILMC) (gold standard). The study variables are the cause of death, sex and age. Sensitivity and percentage of confirmation (PC) with 95% confidence intervals (95% CI) are calculated. Results: The sensitivity of external causes is 59.7% (95% CI:56.5-62.9) and PC is 96.7% (95% CI:94.8-98.0). Traffic injuries, poisonings and suicides are under-reported in the Mor tality Register with a sensitivity lower than 45% and a PC hig her than 80%. Symptoms, signs and ill-defined conditions are over-reported with a sensitivity of 89.2% (95% CI:83.4-93.4) and a PC of 28.0% (95% CI:24.2-32.1). There are no differen ces by sex and age. Conclusions: The validity of the external causes in the Mor tality Register is low due to under-reporting and the high pro portion of symptoms signs and ill-defined causes. According to the results, incorporating information from forensic sources to the Mortality Register increases the quality of mortality statis tics.