Mortality from chronic ischaemic heart disease in the Russian Federation: are there enough data for analysis and decision-making?

Aim. To discuss the role of coding the underlying cause of death based on International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10) in changing the standardized mortality rates (SMR) from various chronic ischaemic heart disease (CIHD) in the Russian Federation in 2014-2023.

Material and methods. The analysis of Rosstat data on the number of patients who died from CIHD and its individual forms for 2014-2023 was performed in accordance with the Brief Nomenclature of Causes of Death of Rosstat. The calculations were performed using the computer program "Calculation and Analysis of Mortality Rates and Years of Life Lost as a Result of Premature Mortality in the Subjects of the Russian Federation" developed at the National Medical Research Center for Therapy and Preventive Medicine. For SMR estimation, the World Health Organization European Standard Population (1976) was used. Accumulation, adjustment and systematization of the original information were carried out in Microsoft Office Excel 2016.

Results. In the Russian Federation as a whole, the SMR from CIHD decreased by 14,6% in 2014-2023 (from 196,2 to 167,5 per 100 thousand population). The share of CIHD in all-cause mortality did not change significantly, while its share in all ischaemic heart disease forms increased annually. We found a decrease in SMR from "I25.0 Atherosclerotic cardiovascular disease, so described" (by 82,5%), "I25.1 Atherosclerotic heart disease" (by 22,3%), "I25.9 CIHD, unspecified" (by 84,1%) against the background of an increase in the group of other forms of CIHD (I25.2-6.8) (by 40%) with an increase in the contribution of CIHD from 25,37 to 41,32%. The proportion of CIHD without clinical criteria (I25.0-1.9) remains high (~60%).

Conclusion. Tendencies towards a decrease in mortality from CIHD were revealed with an increase in the proportion of CIHD in all ischaemic heart disease forms. The share of unspecified codes and forms of CIHD as the cause of death has decreased. There is a need for uniform Russian guidelines, in which CIHD classification according to ICD-10 would be adapted to clinical terminology and the most probable clinical variants of the disease course and causes of death. Clarification of criteria and typification of coding approaches will contribute to a better understanding of the causes and subsequent adoption of targeted management decisions.

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