[Updating of the official statistics of deaths causes: "Let's get stronger after the COVID-19 pandemic".] / Actualización de la estadística oficial de defunciones por causas: "Salgamos reforzados tras la pandemia de la COVID-19".

The National Spanish Institute of Statistics (INE) website is the main means of communication for official statistics in Spain. The INE publishes the annual statistics of deaths according to the cause of death. This vital statistic has improved a lot in recent years; also, thanks to the collaboration from the Autonomous Communities. There are certain areas that could optimize its usefulness. Indicator improvements could include provisional case-counts by causes of death, besides the age-standardization of specified causes of death and the Potential Years of Life Lost by cause of death, for territorial comparison. Meanwhile, the usefulness of social indicators applied to the statistics of death causes could be enhanced, as is the case of education. By updating the databases, it would be possible to maintain the registries of deceased and their causes of death without an annual closure before the statistical publication. Moreover, we could link the databases of demographic records of the population to their health files, to obtain individually the people at risk of sickness or death, and to enable their respective vital, social, health trajectories for statistics. In this way, the INE would increase its leadership and reference on mortality statistics in Spain and EuroStat, as well. Furthermore, the State, Autonomous and municipal administrations could redefine their publication offer into a more specified or innovative statistics of death causes.

El portal del Instituto Nacional de Estadística (INE) es el principal medio de comunicación de la estadística oficial de España. El INE publica la estadística anual de defunciones según la causa de la muerte. Dicha estadística ha mejorado mucho en los últimos años; también, gracias a la colaboración con las Comunidades Autónomas. Existen determinadas áreas que podrían optimizar su utilidad. Entre las mejoras en los indicadores estadísticos podrían estar: los recuentos provisionales de casos por causas de muerte; la estandarización por edad para su comparación interterritorial de las causas específicas y de los años potenciales de vida perdidos según causa; además de la extensión territorial de los indicadores al municipio. A la vez que se podría reelaborar la utilidad de los indicadores sociales aplicados a la estadística de causas de muerte como es el caso de la educación. En la actualización de los registros, cabría: mantener las bases de datos de los fallecidos y sus causas sin el cierre anual tras la publicación estadística e interconectar los registros demográficos de población y los archivos sanitarios para poder disponer individualmente de las personas a riesgo de enfermar o morir, junto con sus respectivas trayectorias sociosanitarias y vitales. Así, el INE acrecentaría su liderazgo y utilidad en la estadística de mortalidad en España y ante EuroStat. Igualmente, las administraciones estatal, autonómica y municipal podrían redefinir su oferta de publicación a una estadística de mortalidad más específica o innovadora.

Primer bienio de estadísticas de mortalidad con el codificador automático Iris de causas de muerte / First biennium of mortality statistics with, the automatic system Iris for coding multiple causes of death

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[Review of mortality from hypertensive disease and diabetes mellitus after the error because of new death certificate: region of Murcia, Spain, 2009]. / Revisión de la mortalidad por diabetes mellitus y enfermedad hipertensiva tras el error detectado en el nuevo certificado de defunción: Región de Murcia en 2009.

BACKGROUND: The Medical Death Certificate and the Death Statistics Bulletin were unified and implemented in the year 2009 in Spain. National statistics detected an unusual increase for diabetes mellitus (DM) and hypertensive disease (HT) deaths in 2009, in relation to previous years trend.The objective is to study the documental causes of the increase, and describe the procedures and consequences in rates, after the revision and recodification of DM and HT. METHODS: All death certificates in 2009 for diabetes and hypertension in the Region of Murcia (cases=670) were revised, according to previous guidelines for direct recoding after consultation to the certifying physician. A telephone survey to certifying physician was designed to determine the accuracy of the pattern of recoding. Kappa index and 95% confidence intervals (95%CI) were performed between initial and recoded causes. Confirmation rate and 95%CI was estimated after phone inquiry to the certifying physician, and the annual age-adjusted and age-specific rates from 1999 to 2009 (uncorrected and corrected) for DM and HT were calculated. RESULTS: Simple agreement was 37% for DM and 30% for HT. The Kappa index between the initial and final causes was 49% (95%CI, 45 to 54%). Confirmation rates were 47% (95%CI, 43 to 52%) for DM and 38% (95%CI, 34 to 43%) for HT. The initial annual rates of 2009 for DM were corrected from 21.4 per 100,000 inhabitants to 17.1, and from 19.0 to 14.0 for hypertension. The respective specific age rates of 70 to 84 and older experienced similar reductions. CONCLUSIONS: The revision restored temporal trends in mortality of DM and HT in 2009, and identified no variations from previous years. It was detected that the erroneous fulfillment of DM AND HT came from the new death certificate.

Revisión de la mortalidad por diabetes mellitus y enfermedad hipertensiva tras el error detectado en el nuevo certificado de defunción. Región de Murcia en 2009 / Review of mortality from hypertensive disease and diabetes mellitus after the error because of new death certificate. Region of Murcia, Spain, 2009

Fundamentos: En el año 2009 se unificó el Certificado Médico de Defunción con el Boletín Estadístico de Defunción (CMD/BED). En la estadística nacional del año 2009 se detectó un aumento inusual en las defunciones por diabetes mellitus (DM) y enfermedad hipertensiva (HTA) en relación a la tendencia en años anteriores. El objetivo del trabajo es estudiar las causas documentales del aumento y describir los procedimientos y consecuencias en las tasas tras la revisión y recodificación de ambas causas. Métodos: Se revisaron todas las certificaciones de defunciones de 2009 por DM e HTA en la Región de Murcia (casos=670) según pautas previas de recodificación directa o tras consulta al médico certificador. Se diseñó una encuesta telefónica al médico certificador para determinar la exactitud de la pauta de recodificación. Se calculó el índice Kappa e intervalo de confianza (IC95%) entre las causas iniciales y recodificadas. Se estimó la tasa de confirmación e IC95% tras consulta telefónica; y las tasas totales y específicas por edad del año 1999 a 2009 con y sin corrección para DM e HTA. Resultados: Los casos concordantes fueron el 37% en DM y 29% HTA. El índice Kappa entre causas iniciales y finales fue del 49% (IC95%, 45-54%). Las tasas de confirmación fueron del 47% (IC95%, 43 a 52%) para DM y del 38% (IC95%, 34 a 43%) para HTA. Las tasas iniciales anuales del año 2009 para DM se corrigieron de 21,4 por cien mil habitantes a 17,1, y de 19,0 a 14,0 para HTA. Las respectivas tasas específicas por edad de 70 a 84 y más años presentaron reducciones similares. Conclusiones: La revisión restableció la tendencia temporal de la mortalidad por DM e HTAen 2009, e identificó que no tuvo variaciones respecto a años anteriores. Se detectó que la cumplimentación errónea de DM e HTA provenía del CMD/BED(AU)

Background: The Medical Death Certificate and the Death Statistics Bulletin were unified and implemented in the year 2009 in Spain. National statistics detected an unusual increase for diabetes mellitus (DM) and hypertensive disease (HT) deaths in 2009, in relation to previous years trend.The objective is to study the documental causes of the increase, and describe the procedures and consequences in rates, after the revision and recodification of DM and HT. Methods: All death certificates in 2009 for diabetes and hypertension in the Region of Murcia (cases=670) were revised, according toprevious guidelines for direct recoding after consultation to the certifying physician. A telephone survey to certifying physician was designed to determine the accuracy of the pattern of recoding. Kappa index and 95% confidence intervals (95%CI) were performed between initial and recoded causes. Confirmation rate and 95%CI was estimated after phone inquiry to the certifying physician, and the annual age-adjusted and agespecific rates from 1999 to 2009 (uncorrected and corrected) forDMand HT were calculated. Results: Simple agreement was 37% for DM and 30% for HT. The Kappa index between the initial and final causes was 49% (95%CI, 45 to 54%). Confirmation rates were 47% (95%CI, 43 to 52%) for DM and 38% (95%CI, 34 to 43%) for HT. The initial annual rates of 2009 forDM were corrected from 21.4 per 100,000 inhabitants to 17.1, and from 19.0 to 14.0 for hypertension. The respective specific age rates of 70 to 84 and older experienced similar reductions. Conclusions: The revision restored temporal trends in mortality of DM and HT in 2009, and identified no variations from previous years. It was detected that the erroneous fulfillment of DMAND HT came from the new death certificate(AU)

Razones de comparabilidad total y por sexo entre la CIE-9 y la CIE-10 en las listas de mortalidad del INE y las de la Región de Murcia / Comparability rathios of the total and by sex between ICD-9 and ICD-10 for the mortality lists of Murcia and the National Institute of Statistics of Spain

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Certifica : Autoformación Médica para la Certificación de la Defunción

Incluye cinco unidades didácticas con aspectos jurídicos y documentos, sobre la importancia y usos de las estadísticas de defunción y un banco de casos, basados en la experiencia real de los registros de mortalidad, para que se ejerciten los alumnos. La versión que aparece en la página web de Murciasalud se ha realizado únicamente en castellano, para utilizar la aplicación en otro idioma hay que descargarla a través del enlace que proporcionan en la misma página.

[Correspondences from 10th to 9th Revision of the International Classification of Diseases in the causes of death lists of the National Institute of Statistics and the Regional Health Authority of Murcia in Spain]. / Correspondencias entre CIE-10 y CIE-9 para las listas de causas de muerte del Instituto Nacional de Estadística y de la Región de Murcia.

BACKGROUND: Different countries have conducted comparability studies between Revisions 10 and 9 of the International Classification of Diseases for aggregate lists of causes of death. In Spain, the COMPARA project was aimed at evaluating the impact of the revision change. METHODS: Descriptive cross-sectional epidemiological study of 88,048 deaths recorded in Spain in 1999 with the underlying cause of death doubled coded in ICD-9 and ICD-10. The theoretical correspondences between the ICD on the lists of the National Institute of Statistics and Murcia are established. The comparability rates and their confidence intervals, and the total kappa index were calculated. RESULTS: A decline in infectious diseases (-1.7%) and viral hepatitis, (-12.3%) declined under Tenth revision, while AIDS showed an increase (5.7%). Neoplasms increased a little (0.3%) with the inclusion of the Mielodisplasic Syndrome (55.2%). Diabetes mellitus is increased (2.1%). Mental disorders declined on dementia being shifted to Alzheimer's disease (28.6%). Cardiovascular diseases dropped slightly (-1.4%), without any impact on cerebrovascular diseases, although acute myocardial infarct decreased (-0.6%) while ischemic heart disease increased (0.3%). Pneumonia decreased (-12.5%) and hepatic cirrhosis grows (4.3%). Ill-defined conditions increased due to cardiorespiratory insufficiencies. The external causes show no change without including the accuracy of ICD-9. The National Institute of Statistics 102 groups list obtained a total kappa index of 95.4%, similar to the Murcia variants. CONCLUSIONS: Although ICD-10 has a lesser overall impact, the significant comparability rates of the causes of death groups between the revisions with important absolute differences should be taken into account.

Correspondencias entre CIE-10 y CIE-9 para las listas de causas de muerte del Instituto Nacional de Estadística y de la región de Murcia / Correspondences from 10th to 9th revision of the International Classification of Diseases in the causes of death lists of the National Institute of Statistics and the regional health authority of Murcia in Spain

Fundamento: Diversos países han realizado estudios de comparabilidadentre las revisiones 10ª y 9ª de la Clasificación Internacionalde Enfermedades para listas agregadas de causas de muerte. EnEspaña el proyecto COMPARA pretende evaluar el impacto delcambio de revisión.Métodos: Estudio epidemiológico transversal descriptivo de88.048 defunciones inscritas en 1999 en España con la causa demuerte doblemente codificada en CIE-9 y 10. Se establecen lascorrespondencias teóricas entre CIE en las listas INE y Murcia. Secalculan las razones de comparabilidad e intervalos de confianza y elíndice kappa global.Resultados: Descienden las enfermedades infecciosas (-1,7%),las hepatitis víricas (-12,3%), mientras que aumenta el Sida (5,7%).Las neoplasias aumentan el 0,3% por la incorporación del síndromemielodisplásico (55,2%). Se incrementa la diabetes mellitus (2,1%).Se reducen los trastornos mentales al salir las demencias hacia laenfermedad de Alzheimer (28,6%). Las enfermedades cardiovascularesdescienden ligeramente (-1,4%), sin impacto sobre las cerebrovasculares,aunque el infarto agudo de miocardio decrece (-0,6%)con aumento de la enfermedad isquémica cardiaca (0,3%). La neumoníadecrece (-12,5%) y la cirrosis hepática se aumenta (4,3%).Las entidades mal definidas aumentan por la cesión de las insuficienciascardiorrespiratorias. Las causas externas no varían sin querecojan la precisión de la CIE-9. La lista INE - 102 grupos obtiene uníndice kappa del 95,4%, similar a las variantes de Murcia. Conclusiones: Aunque el impacto global de la CIE-10 es menor,se deberían tener en cuenta las razones de comparabilidad significativasde los grupos de causas de muerte con diferencias absolutasimportantes entre las revisiones

Background: Different countries have conducted comparabilitystudies between Revisions 10 and 9 of the International Classificationof Diseases for aggregate lists of causes of death. In Spain,the COMPARA project was aimed at evaluating the impact of therevision change.Methods: Descriptive cross-sectional epidemiological study of88,048 deaths recorded in Spain in 1999 with the underlying cause ofdeath doubled coded in ICD-9 and ICD-10. The theoretical correspondencesbetween the ICD on the lists of the National Institute ofStatistics and Murcia are established. The comparability rates andtheir confidence intervals, and the total kappa index were calculated.Results: A decline in infectious diseases (-1.7%) and viral hepatitis,(-12.3%) declined under Tenth revision, while AIDS showed anincrease (5.7%). Neoplasms increased a little (0.3%) with the inclusionof the Mielodisplasic Syndrome (55.2%). Diabetes mellitus isincreased (2.1%). Mental disorders declined on dementia being shiftedto Alzheimer's disease (28.6%). Cardiovascular diseases droppedslightly (-1.4%), without any impact on cerebrovascular diseases,although acute myocardial infarct decreased (-0.6%) while ischemicheart disease increased (0.3%). Pneumonia decreased (-12.5%) andhepatic cirrhosis grows (4.3%). Ill-defined conditions increased dueto cardiorespiratory insufficiencies. The external causes show nochange without including the accuracy of ICD-9. The National Instituteof Statistics 102 groups list obtained a total kappa index of95.4%, similar to the Murcia variants. Conclusions: Although ICD-10 has a lesser overall impact, thesignificant comparability rates of the causes of death groups betweenthe revisions with important absolute differences should be takeninto account