GOVERNMENT OF INDIAGOVERNMENT OF INDIA
A Digital India Initiative

Rajkot : Analysis of heart disease-related mortality : 2013-2018

August 6, 2019 Author : sanjay gohil

Background

Identifying a single disease as the underlying cause of death is an oversimplification of the clinical-pathological process leading to death. The multiple causes of death approach examines any mention of a disease in death certificates. Taking heart disease as an example, the study investigates: patterns of death certification, differences in mortality figures based on the underlying cause of death and on multiple causes of death, factors associated to the mention of heart disease in death certificates, and potential of multiple causes of death in the analysis of the association between chronic diseases.

Process

The whole mortality archive of the Rajkot Municipal Corporation was extracted from 2014 to 2018. Mortality rates and proportional mortality were computed for heart disease as the underlying cause of death and as multiple causes of death. The position of the death certificate where heart disease was mentioned was analyzed. A subset of 3,126 death certificates of known heart patients (identified from the archive of exemptions from medical charges) was analyzed, with mention of heart disease as the outcome and characteristics of subjects as well as other diseases reported in the certificate as predictors.

Table . 1

Disease 2013 2014 2015 2016 2017 2018 Total %
Heart Disease 752 476 710 603 295 290 3126 0.037
Other 12403 12964 12807 13413 14909 14660 81156 0.963
Total Mortality 13155 13440 13517 14016 15204 14950 84282 1.000

Year wise mortality from heart disease selected as the underlying cause of death (UCOD), or mentioned in any position of the death certificate: Rajkot Municipal Corporation, 2013–2018.

Table . 2

Diseases 2013 2014 2015 2016 2017 2018 Total
Male Female Male Female Male Female Male Female Male Female Male Female
Heart Disease 446 306 257 219 415 295 414 189 184 111 184 106 3126
Other 7220 5183 7692 5272 7545 5262 7896 5517 8858 6051 8630 6030 81156
Total Mortality 7666 5489 7949 5491 7960 5557 8310 5706 9042 6162 8814 6136 84282

Gender and Year wise Proportional mortality by from heart disease selected as the underlying cause of death (UCOD), or mentioned in any position of the death certificate: Rajkot Municipal Corporation, 2013–2018.

Analysis of heart disease-related mortality in the whole regional archive

Out of 84,282 deaths in the regional population in 2013 to 2018, heart disease was mentioned in 3126 decedents (0.037 %). The M/F ratio was 1.55. Table 1 shows that in approximately 3.7 %  (i.e. 3126) of certificates, heart disease was mentioned heart disease as a UCOD. In these cases, 1900 were Male and 1226 Female. its selection as the UCOD was highly improbable. When heart disease was reported in Part I on the underlying cause line, a large proportion of certificates 96.3 % (i.e.81156) also mentioned other diseases on the same line. From above data we can also see that as compared to 2013 where 752 people died due to heart disease in 2018 only 290 people died. This shows that the heart treatment facilities are getting better. In same period total mortality increased from 13155 to 14950.

Conclusions

The use of multiple causes of death makes the analysis of mortality data more complex, but conveys more information than usual underlying cause of death analyses.

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