Original ArticlesValidation of death certificate diagnosis of out-of-hospital sudden cardiac death☆
Section snippets
Study participants
The MHHP was a community trial of cardiovascular disease prevention conducted during the 1980s in 3 intervention and 3 matched control communities located in Minnesota, North Dakota, and South Dakota. The MHHP research design2 and its morbidity and mortality results have been published elsewhere.3 In the state of Minnesota, mortality surveillance data before 1985 (1980 to 1984) could not be used because the location of death was not reliably determined. Thus, analysis presented here is based on
Results
Of the total 4,244 deaths documented between 1985 and 1990, the death certificate information identified 2,035 that occurred out of hospital (48%) (Table I). Of the 4,244 deaths, 10% happened in the outpatient setting, emergency room, or on arrival to the hospital, and 38% took place in private homes, nursing homes, medical offices, or prisons.
Table II gives the distribution of death certificate diagnosis of all out-of-hospital deaths. In 19% of the 2,035 cases, the first contributory
Discussion
The main objective of this study was to determine the level of agreement between alternative methods to assess OOH-SCD: (1) economical forms of ascertainment based on death certificate information alone (ICD-9 codes plus location of death); and (2) a more labor and time-intensive standard approach based on physician review of paper death certificate, autopsy reports, medical records, and informant interview. The economical methods performed poorly, but may nevertheless be useful for some
Acknowledgements
We wish to thank William L. Baker and Lois Murphy for their technical assistance.
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This study was supported by a Grant RO1 HL 25523 from the National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland.