Accuracy of mortality indicators due sepsis-associated deaths in the Federal District
DOI:
https://doi.org/10.17058/reci.v13i1.17621Keywords:
Sepsis, Data Accuracy, Cause of Death, Death CertificatesAbstract
Background: Sepsis currently represents a challenge for health systems, this fact may be related to the spread of bacterial resistance, the increase in the population of elderly, immunosuppressed individuals, and the improvement of emergency care, favoring the survival of critically ill patients. This article aimed to evaluate the accuracy of mortality indicators due to sepsis in 2018. Method: Validation study of death certificates that occurred in the Federal District in 2018. Declarations whose basic causes of death identified were classified as garbage codes were identified, which were investigated by a multidisciplinary team, capable of reclassifying them with codes that allow for the improvement of health data. In order to assess accuracy, sensitivity, specificity, positive and negative predictive values, positive and negative likelihood ratios of death certificates from sepsis were calculated, with 95% confidence intervals. Results: A total of 6.244 statements were evaluated, of which 233 (3.74%) presented sepsis as the underlying cause before being investigated and only 35 (0.56%) maintained it after the investigation. The filling of statements with sepsis as the underlying cause by physicians showed a sensitivity of 0.9% (95%CI: 0.6 to 1.3) and a specificity of 92.0% (95%CI: 90.9 to 93.1). Conclusion: The low accuracy of the declarations demonstrates the non-reliability of the underlying cause of death from sepsis, especially the completion of death certificates that occurred in the Federal District in 2018.
Downloads
References
Cecconi M, Evans L, Levy M, et al. Sepsis and septic shock. The Lancet. 2018;392(10141):75–87. https://doi.org/10.1016/S0140-6736(18)30696-2
Napolitano LM. Sepsis 2018: Definitions and Guideline Changes. Surgical Infections. 2018;19(2):117–25. https://doi.org/10.1089/sur.2017.278
Taeb AM, Hooper MH, Marik PE. Sepsis: Current Definition, Pathophysiology, Diagnosis, and Management. Nutr Clin Pract. 2017; 32(3): 296–308. https://doi.org/10.1177/0884533617695243
Neviere R. Sepsis syndromes in adults: Epidemiology, definitions, clinical presentation, diagnosis, and prognosis. UpToDate. 2020. https://www.uptodate.com/contents/sepsis-syndromes-in-adults-epidemiology-definitions-clinical-presentation-diagnosis-andprognosis?search=sepse%20fatores%20de%20risco&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1
Instituto Latino-Americano para Estudos da Sepse. Sepsis: a public health problem. Brasília: Conselho Federal de Medicina; 2015. 89 p.
Miquelin PR de S, Reis GR. Comparison between the morbidity and mortality rates of patients with septicemia in all federation states and the Federal Districtl. Amazônia: Science & Health. 2016;4(4):20–4. http://ojs.unirg.edu.br/index.php/2/article/view/1374
Instituto Brasileiro de Geografia e Estatística. Cidades. https://cidades.ibge.gov.br/brasil/df/panorama
Instituto Brasileiro de Geografia e Estatística. SIDRA. Sustainable Development Indicators. https://sidra.ibge.gov.br/tabela/1174.
Secretária de Saúde do Distrito Federal. Vigilância à Saúde. Brasília: Secretária de Saúde do Distrito Federal. 2022. https://www.saude.df.gov.br/vigilancia-a-saude
Ministério da Saúde (BR), Fundação Nacional de Saúde. Instructions Manual for Filling the Death Certificate. 3ª edição – Brasília: Assessoria de Comunicação e Educação em Saúde (ASCOM); agosto de 2001.
Santos MR, Cunha CC, Ishitani LH, et al. Deaths from sepsis: underlying causes of death after investigation in 60 Brazilian municipalities in 2017. Revista Brasileira de Epidemiologia. 22(supl. 3), 2019. https://doi.org/10.1590/1980-549720190012.supl.3
Pereira JM. Profile of patients diagnosed with sepsis in Intensive Care Unit in a university hospital in Distrito Federal. [Brasília]: Universidade de Brasília (UnB); 2018.
Benedetti MSG, Saraty SB, Martins AG, et al. Evaluation study of the garbage codes research project in the Northern region of Brazil. Rev Bras Epidemiol. 2019;22(supl. 3):e19006. https://doi.org/10.1590/1980-549720190006.supl.3
Akhade SP, Dash SK, Akhade KS. The knowledge assessment and reducing the errors of medical certificate of cause of death with sensitization training of physicians: A quality improvement intervention study. Journal of education and health promotion. 2022; 11, 1-7. https://doi.org/10.4103/jehp.jehp_502_21
Makinde OA, Odimegwu CO, Udoh MO, et al. Death registration in Nigeria: a systematic literature review of its performance and challenges. Global health action, 2020; 13(1). https://doi.org/10.1080/16549716.2020.1811476
Nyondo T, Msigwa G, Cobos D, et al. Improving quality of medical certification of causes of death in health facilities in Tanzania 2014-2019. BMC health services research, 2021; 21(Suppl 1). https://doi.org/10.1186/s12913-021-06189-7
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Fernanda Alves Ramires , Cauê Sousa Cruz e Silva , Luísa Caroline Costa Abreu , Ana Laura de Queiróz Pereira, Elaine Ramos de Moraes Rego , Delmason Soares Barbosa de Carvalho , Elivan Silva Souza , Amanda Oliveira Lyrio, Sarah dos Santos Conceição , Ana Claudia Morais Godoy Figueiredo , Josicélia Star Tuy Batista
This work is licensed under a Creative Commons Attribution 4.0 International License.
The author must state that the paper is original (has not been published previously), not infringing any copyright or other ownership right involving third parties. Once the paper is submitted, the Journal reserves the right to make normative changes, such as spelling and grammar, in order to maintain the language standard, but respecting the author’s style. The published papers become ownership of RECI, considering that all the opinions expressed by the authors are their responsibility. Because we are an open access journal, we allow free use of articles in educational and scientific applications provided the source is cited under the Creative Commons CC-BY license.
