Death Certificate Analysis at Colombian Orinoquia: A Retrospective Observational Trial.

Study Overview
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Brief Summary
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By hospital mortality, the health of a population is identified. Death certificates are a valuable tool in establishing causes of death. The objective will be to analyze the main causes of death in hospitalized patients by population groups of interest. A retrospective observational study will be carried out, by analyzing the death databases of the Hospital Departamental of Villavicencio from January 2012 to May 2022. The records will be exported to Excel for review and debugging. Demographic variables and causes of death will be analyzed. The categorical variables will be described in frequency and proportion; the quantitative ones will be defined in their central distribution and dispersion. For comparison, the Chi-square and Mann-Whitney test will be performed according to the characteristics of the outcome studied. It is expected to identify the main causes of death in the groups of interest (adults, maternal, infants, fetal and non-fetal, congenital malformations) and their characteristics.

Detailed Description
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Hospital mortality is a measure of the effectiveness of interventions in health, and its systematic evaluation is convenient, as an indicator of clinical management. It is considered that in internal medicine services, it can be between 6-21%, which depends on its complexity. and the population of influence. The identification of hospital causes of death (COD) makes it possible to recognize the prevailing public health problems in the population. This information is relevant for decision-making, planning, and directing public and institutional policy. Hospital mortality is an important source of these data, in a region where most deaths occur at hospital settings. The proportion of deaths in hospitals is growing internationally and in Villavicencio, this could be the case in most cases. There are few alternatives for palliative care and end-of-life care in low and middle-income countries. Few studies analyze information from hospital institutions. Access to death indices is free in countries such as Spain, in order to allow studies on the health of the population. Even so, there is concern about the quality of the records, from health organizations, although the uncertainty that involves establishing the COD does not necessarily conflict with the precision of metrology, according to more pragmatic thoughts. The death certificate (CD) is the main source of data on mortality. CDs are the legal record of the causes of death and are usually made by health personnel, mainly doctors. Such information is essential to establish the priorities in health policies, of each individual institution, and in the general population. They collectively indicate the state of health of a nation. Uncertainty about the cause of death can be a significant challenge in scenarios such as unexpected death or after a prolonged period without medical attention. Errors in completing the information on CDs are recognized as a universal problem, which can lead to confusion in the prevalence of causes of death (COD). The use of ill-defined codes and conditions (CCMD) as COD is frequent at a universal level. Some have considered that the doctor should be socialized with the vital status and COD of their patients.

Official Title
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Death Certificate Analysis and Mortality at a Hospital From Colombian Orinoquia: A Retrospective Observational Trial.

Conditions
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Hospital Mortality, Cancer, Chronic Disease, Non Communicable Chronic Diseases, Public Health

Intervention / Treatment
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* Other: Risk factor


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Deceased people during hospitalization. Out-of-hospital deceased people (home) and certified by the institution Exclusion Criteria: Registers of people deceased by an external (violent) cause. Registers of people that required certification by the Coroner's office.

Ages Eligible for Study
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Maximum Age: 120 Years

Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Cancer<br>Death certificates of patients died by cancer or with cancer. | Other: Risk factor<br>* No diagnostic or therapeutic intervention; the characteristics of subgroups will be analyzed by the cause of death certificated in the registry.<br>* Other names: Cause of death;|
| Cardiovascular<br>Death certificates of patients died by cardiovascular conditions or complications. | Other: Risk factor<br>* No diagnostic or therapeutic intervention; the characteristics of subgroups will be analyzed by the cause of death certificated in the registry.<br>* Other names: Cause of death;|
| Tuberculosis<br>Death certificates of patients died by or with tuberculosis, including patients with HIV. | Other: Risk factor<br>* No diagnostic or therapeutic intervention; the characteristics of subgroups will be analyzed by the cause of death certificated in the registry.<br>* Other names: Cause of death;|
| Infants<br>Death certificates of pediatric patients with more than a month of birth, and less than 18 years old. | Other: Risk factor<br>* No diagnostic or therapeutic intervention; the characteristics of subgroups will be analyzed by the cause of death certificated in the registry.<br>* Other names: Cause of death;|
| Congenital malformations<br>Death certificates of patients died by congenital malformations, independently of age. | Other: Risk factor<br>* No diagnostic or therapeutic intervention; the characteristics of subgroups will be analyzed by the cause of death certificated in the registry.<br>* Other names: Cause of death;|
| Maternal<br>Death certificates of patients died by obstetrical conditions during pregnancy or delivery. | Other: Risk factor<br>* No diagnostic or therapeutic intervention; the characteristics of subgroups will be analyzed by the cause of death certificated in the registry.<br>* Other names: Cause of death;|
| Contagious<br>Death certificates of patients died by contagious/infectious diseases. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of preventable deaths | Deaths caused by diseases or conditions potentially preventable, according to the Holland criteria, or other authors. | 12 years | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Death Certificate, Hospital Mortality, Epidemiology, Public Health, Cancer, Geriatrics, Neoplasms, Colombian Orinoquia, Colombia