Medical death certificates: frequency of autopsies and place of death

There is variability in the frequency of autopsies and place of death among countries around the world.

Purpose. To conduct a comparative analysis of the place of death and the frequency of autopsies of the urban and rural population depending on the class of diseases in the regions of the Central Federal District (CFD) of the Russian Federation.

Materials and methods. The Rosstat table “Distribution of the deceased by source of information about the deceased and place of death in 2022”, urban and rural population were used. 11 of 22 classes of diseases according to the ICD-10 were selected for analysis, since their share in regional mortality is more than 95%.

Results. The frequency of autopsies in the event of death of urban residents of the CFD from any cause (70.64±14.79%) is higher than that of rural residents (61.69±15.49%; p=0.09). The largest proportion of autopsies was observed in cases of death from infectious diseases (ID) (on average 87.6±21.1% urban population and 82.3±26.6% rural; maximum 100%; minimum 53.5%) and external causes (EC) (more than 99% in all regions of the CFD). The minimum proportion of autopsies was registered in class R “imprecisely identified causes” (31.29 ± 27.47; minimum 4% and maximum 95%), and in class G “Diseases of the nervous system” (DNS) (35.51±29.77; minimum 32.25%; maximum 97.5%). The regional average proportion of deaths in hospital (from all causes 39.19±5.37% urban and 32.38±5.04% rural; p<0.0001) was the highest in the case of death from ID (79.14±10. 8% urban population, 76.32±11.25% rural) and minimum in three classes: DNS, R and EC. Regional average proportion of deaths at home (from all causes 45.04±6.64% urban and 52.38±6.04% rural population: p=0.002) The highest proportion of deaths at home was registered in the class of DNS (rural population 77.51±7.99%; maximum 88% and minimum 13%).

In case of death from external causes, the “scene of the incident” was the place of death, with a maximum in the Kostroma region (58.8%; rural population) and a minimum in the Lipetsk region (14.3%; urban population) and in Moscow (16.2%).

Conclusions. Significant interregional variability in the frequency of autopsies and place of death was revealed depending on the specified class of cause of death and place of residence (urban/rural).