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Doctoral Thesis
DOI
https://doi.org/10.11606/T.6.2003.tde-05022021-145118
Document
Author
Full name
Ana Maria Sanches
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2003
Supervisor
Committee
Laurenti, Ruy (President)
Giannotti Filho, Osvaldo
Mello Jorge, Maria Helena Prado de
Pasqualucci, Carlos Augusto Goncalves
Saldiva, Paulo Hilario Nascimento
Title in Portuguese
Acurácia do preenchimento dos atestados de óbito com a validação diagnóstica por meio das autópsias realizadas em hospital universitário do município de São Paulo, 2001
Keywords in Portuguese
Atestado de Óbito
Autópsia
Causa Básica de Morte
Hospitais Universitários
Abstract in Portuguese
Este trabalho teve por objetivo avaliar a acurácia na declaração da causa básica de morte nos atestados de óbito comparando-os com a história clínica e autópsia de casos de pacientes falecidos no ano de 2001 em um Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo do Município de São Paulo. É um estudo transversal com delineamento observacional, aferição histórica e não controlado. Os resultados demonstraram que, dos 258 óbitos estudados, 213 (82,5%) apresentaram concordância e 45 (17,5%) discordância na análise da história clínica x autópsia, história clínica x atestado de óbito e atestado de óbito x autópsia. Dos 45 óbitos, 28 (62%) apresentaram discordâncias entre o atestado de óbito x autópsia e 17 (38%) concordâncias entre o atestado de óbito e autópsia. Desses 28 óbitos, 27 apresentaram as causas consequenciais de morte da Parte I do atestado de óbito preenchidos incorretamente e apenas 1 (um) apresentou a causa básica de morte preenchido incorretamente. Na Parte II do atestado de óbito não houve mensão de fatores de risco como tabagismo, obesidade, etilismo e outros, quando referidos na história clínica. O mesmo ocorreu com os intervalos entre o início da doença e a morte. Portanto, mesmo sendo considerados "padrão ouro", os diagnósticos de autópsia, os atestados de óbito não foram preenchidos corretamente e portanto a acurácia de 100% que se esperava não foi atingida.
Title in English
Accuracy of the basic cause of death declared on death certificates agaunst the clinical history and the autopsy reports of deceased patients in the year 2001 at a University Hospital in the City of São Paulo
Keywords in English
Autopsy
Hospitals (University)
Underlying Cause of Death
Abstract in English
This work intends to evaluate the accuracy of the basic cause of death declared on death certificates against the clinical history and the autopsy reports of deceased patients in the year 2001 at a University Hospital in the City of São Paulo. It is a transverse study with observational delineation, historical gauging and not controlled. The results showed that amongst 258 studied deaths 213 (82,5%) were consistent with the clinical history x autopsy, clinical history x death certificate and death certificate x autopsy and 45 (17,5%) were inconsistent with the clinical history x autopsy, clinical history x death certificate and death certificate x autopsy. Amongst 45 deaths, 28 (62%) were inconsistent with death certificate x the autopsy and 17 (38%) were consistent with death certificate and the autopsy. Amongst 28 deaths, 27 presented the causes of death in Part I of the death certificate filled incorrectly and only one presented the basic cause of death filled incorrectly. In Part II of the death certificate there was no mention of risk factors as tobaccoism, obesity, alcoholism and others, when related in clinical history. The same occurred with the intervals between the beginning of the illness and the death. Therefore, although the autopsy diagnosis were highly considered, the death certificates had net been filled correctly and the 100% expected accuracy was not reached.
 
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Publishing Date
2021-02-05
 
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