OBJECTIVE

To compare the leading causes of death at home in the Moscow region in 2019 and 2021 according to primary data of medical certificates of cause-of-death (MCC).

MATERIALS AND METHODS

The electronic database data of the Main Directorate of the Civil Registry Office of the Moscow Region (the Unified State Register of the Civil Registry Office system) were analyzed. In total, 88.156 deaths were recorded in 2019 and 115.993 in 2021, of which 42.4% and 33.4% were at home, respectively. The primary or underlying causes of death (PCD) by ICD classes and individual causes of death within the class were analyzed.

RESULTS

Mortality rates from all causes at home increased by 2.2% (489 to 500 per 100.000 people). The average age of death was 74.0±14.9 years in 2019 and 74.2±15.0 years in 2021. The four ICD classes accounted for 80% of deaths in 2019 and 88% of in 2021: diseases of the circulatory system (35.2% and 38.5%), nervous system diseases (21.5% and 28.5%), neoplasms (16.8% and 15.6%) and not otherwise specified conditions — class 18 (6% and 5.6%). The proportion of COVID-19 deaths at home in 2021 was 0.8%. The “shift” of the causes of death was revealed: mortality from alcoholic cardiomyopathy (I42.6) was 1.4 in 2019 and 11.8 per 100 thousand of the population in 2021; from alcohol dependence syndrome (F10.2) — 13.4 in 2019 and 0.7 per 100 thousand of the population in 2021. Almost 60% of the MCC indicated not otherwise specified causes of death (of which the most frequently reported encephalopathy not otherwise specified (G93.4) — 12.8% and 20% of all deaths).

CONCLUSIONS

Leading causes of death at home were those for which clinically unspecified ICD codes were used. In 2021, compared to 2019, there was an increase in the frequency of use of such codes. The causes of death at home need further clarification.