Discrepancy of the Cause of Death in Autopsy Cases of Cardiovascular Disease with a Focus on Cause of Death Statistics

Abstract

Determining the cause of death (COD) is important not only as personal information, but also as social statistical data. An autopsy is the gold standard for investigating death and determining the COD. CODs determined by an autopsy in countries with low autopsy rates, such as Korea, can serve as important data in constructing nationwide statistics. We compared and analyzed cases of CODs corresponding with the same cases of cardiovascular disease determined by autopsy and CODs from Statistics Korea. Among autopsies performed in Korea during 2015, the present study selected 1,920 cases of cardiovascular disease as the COD and analyzed 1,468 of those that could be confirmed by Statistics Korea. Main CODs included ischemic heart disease, acute myocardial infarction, sudden cardiac death, intracerebral hemorrhage, subarachnoid hemorrhage, aortic aneurysm and dissection, pulmonary embolism, and esophageal varix. Among these, COD by autopsy was confirmed with Statistics Korea data in more than 90% of cases involving acute myocardial infarction, intracerebral hemorrhage, subarachnoid hemorrhage, and aortic aneurysm and dissection, whereas cases involving ischemic heart disease, sudden cardiac death, pulmonary embolism, and esophageal varix showed a relatively wide variety of CODs from Statistics Korea. It is believed that forensic autopsies should be effectively reflected for more accurate COD statistics. Thus, final CODs from Statistics Korea should be determined based on careful discussions between the forensic pathologist and staff in charge at Statistics Korea, and a systematic upgrade that would allow for reconfirmation of the final COD is necessary.