Evaluation of the quality of mortality information by unspecified accidents and events of undetermined intent in a metropolis of Southeastern Brazil

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.