Evidence of large systematic differences between countries in assigning ischaemic heart disease deaths to myocardial infarction: the contrasting examples of Russia and Norway
| Autor: | Per Magnus, Evgeny Andreev, David A. Leon, Sergey Timonin, Vladimir M. Shkolnikov |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Epidemiology
validity of causes of death Myocardial Infarction Myocardial Ischemia Autopsy Coronary Artery Disease Russia ischaemic heart disease Humans Medicine AcademicSubjects/MED00860 Myocardial infarction autopsies Cause of death Norway business.industry Time trends Mortality rate General Medicine medicine.disease Miscellaneous Place of death Mortality data Ischaemic heart disease business place of death Demography |
| Zdroj: | International Journal of Epidemiology |
| ISSN: | 0300-5771 |
| Popis: | Background There is considerable variation in mortality rates from myocardial infarction (MI) across high-income countries, some of which may be artefactual. Methods Time trends in mortality rates from ischaemic heart disease (IHD) and MI were analysed for a set of high-income countries from the end of the 1970s. Using individual-level mortality data from Russia (2005–2017) and Norway (2005–2016), we investigated factors associated with the proportion of total IHD deaths certified as due to MI. Results In most countries, MI mortality rates have dramatically declined from the 1970s. However, the share of MI in total IHD deaths varies substantially across countries. In Russia, only 12% of IHD deaths had MI assigned as the underlying cause vs 63% in Norway. IHD deaths occurring outside of hospital without autopsy were far less likely to be assigned as MI in Russia (2%) than in Norway (59%). Conclusions Although established international criteria for MI require specific clinical or post-mortem evidence, it appears that certifying specialists in different countries may interpret these criteria differently. At one extreme, Russian doctors may only assign MI as a cause of death when there is specific pathophysiological evidence. At the other extreme, their counterparts in Norway may be willing to specify MI as the cause even when this evidence is not available. Internationally established criteria for MI diagnosis are challenging to apply for out-of-hospital deaths. Differences between countries in how certifiers interpret these criteria may account for at least some of the international variation in MI mortality rates. |
| Databáze: | OpenAIRE |
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