[Alcohol-related mortality in the assessments of hospital unit physicians and pathologists: analysis of accounting medical documents].

AIM: To make a comparative analysis of the data available in the accounting medical documents drawn up at a multidisciplinary hospital on the level and structure of alcohol-related mortality (ARM) and to evaluate the efficiency of its accounting. MATERIALS AND METHODS: Accounting medical documents, such as 453 inpatient cards (Form 003/y), 453 postmortem protocols (cards) (Form 013/H-80), and 453 death certificates (Form 106/y-08), were chosen as the basis for the study. The data of the final clinical and postmortem diagnoses in the patients who had died at hospital and their primary cause of death were comparatively analyzed. RESULTS: According to Form 003/y, ARM was 5.5%; the detection rate of alcohol-related disease (ARD) was 11% (95% confidence interval (CI), 8.3 to 14.3%); according to Form 013/H-80, ARM was 7.1% (95% CI, 4.9 to 9.8%) and the detection rate of ARD was 12.6% (95% CI, 9.7 to 16%). The consistency of the diagnoses of ARD as a main cause of death, made by hospital unit physicians and pathologists, is estimated as the mean--the Cohen's kappa coefficient (kappa) is 0.570) (p < 0.001). CONCLUSION: The results of the investigation suggest that there are 3 types of ARM, which differ in its level and structure: ARM in the assessments of hospital unit physicians; that in the assessments of pathologists, and that according to the death certificates drawn up. The consistency index for the diagnosis of ARD as a main cause of death indicates that the hospital unit physicians only determine the etiology of alcohol-related cause of death, without identifying it specifically.

[Socio-demographic status of elderly and senile age people died from alcohol-attributable states in Arkhangelsk].

To determine the characteristics of the socio-demographic status of elderly and senile age people died of alcohol-attributable states in Arkhangelsk, data from the medical certificate of death was analyzed. Data of death for persons who died in the city of Arkhangelsk in the period from 1 July 2011 to 30 June 2012 (one year) were copied out. The vast majority of alcohol conditioned deaths among men occurs in middle (working) age, 1/3 of women--over the age of 60 years. The alcohol-attributable mortality revealed the transformation of the structure of women over the age of 60 years compared with the mature age. Gender and age significantly affect the probability of death from alcohol only attribute states after 60 years. The results of the study indicate a different impact on the character of the individual sociodemographic factors on the probability of death from alcohol-attributable states in elderly and senile age.

[On the problem of registration of mortality associated with alcohol consumption among the population in the forensic medical practice].

The objective of the present study was the comparative analysis of the data obtained from the available medical documentation with a view to estimating the effectiveness of taking into account the mortality associated with alcohol consumption. The data subjected to the analysis included the age and the gender of the deceased subjects, complete forensic medical diagnoses from 1607 expert reports and acts of forensic medical expertise of the corpses (form 171/y), and information about the cause of death (item 19) from the relevant medical death certificates (form 106y/08). The mortality associated with alcohol consumption estimated based on the expert reports and acts of forensic medical expertise of the corpses (form 171/y) amounted to 6.7% (95% CI: 5.5- 8.1%); the occurrence of pathology attributable to alcohol consumption was estimated at 7.2% (95% CI: 5.9-8.5%) of the total number of deaths. It was shown that forensic medical experts do not employ in the full measure the diagnostic potential of the International Classification of Diseases (ICD-10) when having to deal with the mortality associated with alcohol consumption. The results of the study confirm the qualitative transformation of the alcohol attributable mortality structure associated with the transfer of information from the expert reports and acts of forensic medical expertise of the corpses (form 171/y) to the medical death certificates (form 106/y-08).

[The mortality because of conditions related to alcohol consumption].

The article presents the systematization of data concerning alcohol-depended mortality as a occurrence with complicated structure. It is established that grouping of alcohol-depended mortality on isolated components is conditioned by different nature of unhealthy consumption of alcohol in the development of alcohol-depended conditions as a conditional and/or supporting factor. Among other causation factors article points out the input of pattern of alcohol consumption into the value of risk of development of alcohol-attributive conditions and two-way impact of unhealthy alcohol consumption at the risk of development of particular alcohol-attributive conditions.