Mortality from cerebrovascular diseases in the Russian Federation before and during the COVID-19 epidemy: regional differences

Objective. To study regional differences in mortality from cerebrovascular diseases in several regions of the Russian Federation before and during the COVID-19 pandemic. Materials and methods. The dynamics of the structure of mortality from cerebrovascular diseases in the Russian Federation and in several regions before and during the COVID-19 pandemic (2019—2022) was analyzed, and the reliability of mortality rates from cerebrovascular diseases, including acute and chronic forms, was studied. Data for the analysis for 2019—2022 was obtained from statistical reference books of the Ministry of Health of the RF and the Federal State Statistics Service of Russia. Data from regional databases for the 2nd half of 2020 was also used. Results. From 2019 to 2022, there was no general trend in mortality from cerebrovascular diseases or territorial differences in their structure. The expert assessment in the studied regions revealed a correct registration of medical death certificates in 5.1—46.0% of cases. An acute cerebrovascular accident was correctly indicted as the primary cause of death in 93.4—97.5% of cases, and chronic forms of cerebrovascular diseases — in 2.6—46.5% of cases. An over-mortality from cerebrovascular diseases in the studied regions was mainly due to an incorrect selection of chronic forms of cerebrovascular diseases as the primary cause of death before and after the COVID-19 pandemic. After the first year of the COVID-19 pandemic, the expert assessment in the studied regions identified isolated cases of incorrect selection of the primary cause of death in violation of the rules established by ICD-10, with a combination of COVID-19 and cerebrovascular diseases. Conclusion. The deficiencies discovered during the expert assessment led to scientific and methodological seminars and conferences for medical workers on coding morbidity and mortality following ICD-10.