Certificación médica de las defunciones por traumatismos en los servicios de salud de Chile / Analysis of medical certification of deaths by trauma in Chile

Background: Trauma in the third cause of death in Chile and the most important among youngsters. Aim: To analyze the certification of deaths by trauma, studying those deaths in which it is not known if they were accidental or self inflicted. Material and methods: Deaths certified as caused by trauma, poisoning or violence during the period 1992-1994 are analyzed. Those in which their accidental or self inflicted nature was ignored were specially considered. Results: During the study period, 26.886 of 225.796 deaths were certified as caused by trauma, poisoning or violence. In 41.7 percent of these deaths, no defined cause (accidental or self inflicted) was reported. In the Metropolitan region 65.3 percent of deaths by trauma were not defined. Ninety seven percent of certificates in this area were extended by pathologists or coroners. In all health services, there was a positive correlation between the percentage of ill defined deaths by trauma and the percentage of certifications by pathologists or coroners. Conclusions: The deficiency in certification of deaths by trauma is possibly due to administrative causes and precludes the study of deaths caused by accidents, violence or suicide in Chile and its comparison with other countries. An effort should be done to solve this problem

Cáncer de mama: atención de salud y nivel de vida en la mortalidad prematura / Breast cancer: health care and life status in the premature mortality

Se usan 8 indicadores epidemiológicos y once variables en población chilena y su posible relación con cáncer de mama. Se analizan la mortalidad observada y esperada. Se emplean modelos de regresión múltiple para evaluar su efecto en salud. La tasa de 30-34 años, es de 2,9 x 100.000 mujeres y entre 60-64 años es de 46,7 x 100.000. Aumentar la edad en un año, significa incrementar el riesgo de muerte en 1,4 en promedio. Existe gran variabilidad en las diferentes regiones del país, partícularmente en edades tempranas