OBJECTIVE

To analyze the regional features of the mortality structure depending on the place of death and the proportion of autopsies performed for the initial causes of death within the 10 classes of diseases according to the International Classification of Diseases of the 10th Edition in 2022, and to assess their relationship and trends compared to 2013 data.

MATERIALS AND METHODS

Federal State Statistics Service C56 forms, «Distribution of Deaths by Source of Information about the Deceased and Place of Death» for 2013 and 2022 were reviewed. To analyze the primary causes of death (PCD), 10 out of 22 ICD-10 classes of diseases were selected from this database (excluding injuries, poisoning and some other consequences of exposure to external causes (class XIX), COVID-19, as well as classes with share among the causes of death less than 1% (classes III, VIII, XII, XIII, XV, XVI, XVII). For each PCD class, the average regional values of the proportion (necropsy/class of causes of death), standard deviations, and maximum and minimum values were calculated. The correlation between the indicators was assessed using the Spearman method. When comparing the values, differences at p<0.05 were considered statistically significant. SPSS 26.0 (IBM Corporation, USA) and Excel (Microsoft for Microsoft Windows) were used for statistical analysis.

RESULTS

The national average rate of autopsies performed in 2022 was 67.94%, representing an increase of 18.73% from 2013. The highest rate of autopsies was reported for class I causes of death, and the lowest for classes VIII and VI. In the republics of the North Caucasus, the lowest rates of autopsies (<10%) were reported, and the highest rates for all classes of diseases were reported in St. Petersburg and Moscow. The national average percentage of hospital deaths in 2022 was 38.66%, representing a 13.08% increase from 2013. The average regional proportion of hospital deaths was the highest from infectious diseases and the lowest for class VIII causes of death. The national average percentage of home deaths in 2022 was 44.99%, representing a decrease of 11.11% from 2013. A weak correlation was found between the proportion of autopsies and the proportion of hospital deaths; however, the magnitude of this correlation varied from moderate to no correlation for different classes of causes of death.

CONCLUSION

In most regions of the Russian Federation and Russia as a whole, the autopsy rate is significantly higher than in other countries of the world. The percentage of hospital deaths generally corresponds to that in high- and middle-income countries. Studies are needed to identify the causes and validity of significant interregional variability in autopsy rate and place of death.