M. Drumond et al., Evaluation of the quality of mortality information by unspecified accidents and events of undetermined intent in a metropolis of Southeastern Brazil, REV SAUDE P, 33(3), 1999, pp. 273-280
Introduction Mortality data are important for monitoring violence, making i
t possible to assess the trends and the impact of interventions towards its
reduction. The objective of the study is to assess the quality of the fill
ing out and codification of the death certificates for unspecified accident
s and events of undetermined intent in the city of S. Paulo in 1996.
Methods Death certificates on which the underlying cause of death (ICD) giv
en was an unspecified accident(ICD-10 X59) or an event of undetermined inte
nt (ICD-10 Y10-Y34) were selected for investigation at the Legal Medicine i
nstitute (IML). After consulting the police reports which accompany the cor
pses to the IML, the autopsy reports and other legal forms, these were anal
ysed and the UCD was recoded.
Results For unspecified accidents. 53.2% were changed to a specified cause:
15.1% due to pedestrians injured in traffic accidents, 17.5% due to other
traffic accidents and 14.5% due to falls. Homicides and suicides constitute
d 9.8%. in 20.9% no additional information was found. For events, of undete
rmined intent, 2/3 had no clarification; in 1/3 of the cases, the underlyin
g cause changed to falls (10.6%), homicides (7.5%) and pedestrians injured
in transport accidents (6.7%).
Conclusions The quality of mortality information by external causes in the
City of S. Paulo is not satisfactory. The IML has not used ail the availabl
e information to fill out the death certificates. The findings reveal that
the instruction of the World Health Organization and the Brazilian Center f
or the Classification of Diseases to codify as accidents those events for w
hich there is no information on the death certificate about the external ca
use, does not seem 40 be appropriate. In that category 66.0% of the deaths
were found to have been inferred incorrectly as accidental The improvement
of the quality of mortality data due to external causes may contribute to t
he monitoring of violence and may give support to decisions leading to its
reduction whatever the form that violence may take.