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Aim: to analyze the quality of completion medical certificates of death (MCD) of residents of the Tula region, in which in 2017 acute and subsequent myocardial infarction (MI) was listed as the underlying cause of death (UCD) or as multiple causes of death (MC).Materials and methods. From the electronic database (DB) of MCD of residents of Tula region for 2017 we selected all MSD in which MI was written down irrespective of a section of MCD. A total of 689 MSD (43.8% men and 56.2% women) were analyzed.Results. Mean age of the deceased was 72.6±11.3 years (men 67.25±0.62; women 76.7±9.8; pConclusion. Mortality analysis using solely UCD leads to decreasing mortality rates from MI, and unsatisfactory quality of filling the MCD decreases the ability to identify MC, that prevents the correction of priorities in the organization of medical care. The revealed problems of coding causes of death require urgent solutions from the professional community of cardiologists, pathologists, and the Ministry of Health.

For organization of health care, it is important to know the requirement for its individual types, including the number of hospitalizations and the use of expensive technologies. Heart failure (HF) syndrome in patients with cardiovascular diseases often determines their severity and prognosis. However, being a complication of underlying disease, HF is not included into statistical reports and medical bills in the compulsory health insurance system. This article focuses on issues in evaluating HF prevalence and mortality in different countries and provides the authors’ consensus on approaches to HF coding in the informational systems, which record morbidity and mortality.

The review contains data on rates of permanent loss of working ability (disability) after coronary artery bypass grafting (CABG) in Russia and in European populations of patients with ischemic heart disease. According to domestic studies determination of disability status is not based on assessment of objective characteristics of functional reserve of cardiovascular system. Most patients after surgery retain disability status. CABG is not a rehabilitating factor but on the contrary results in increase of number of officially disabled people.

In this article we present data indicative of overestimation of mortality from cardiovascular diseases related to inadequate filling of certificates of causes of death and misuse of ICD-10 codes. Significant errors in coding causes of death result in significant differences in mortality with other countries what precludes correct comparison of mortality from cardiovascular diseases, the development of programs aimed at reducing mortality in the target groups.

to compare and discuss causes of differences between standardized mortality rates (SMR) from diseases of the circulatory system (DCS) among men and women older than 50 years in Russia and USA.Data on mortality rate in the USA were taken from WHO mortality database (WHO MD), those on the USA population by 5-years age bands from Human Mortality Database (HMD). Information on mortality rates in Russia was obtained from Rosstat. In analysis we used age-adjusted death rates and SMR for DCS or ages more or equal 50 years. For standardization of mortality rates we used data of the European Standard Population 2013.By 23 3-digit codes mortality rates among men in USA were higher than in Russia (in the structure of mortality among women there were 28 such codes). Portion of such deaths in Russia in total number of DCS deaths was 6.5% both for men and women, while figures for USA were 36.8 and 40%, respectively. About 99% of differences in SMR from DCS between countries were determined by 8 and 6 groups of causes in men and women, respectively. Analysis of 4-digit ICD codes showed that almost 40% of DSC class deaths both in Russia and USA had the forth digit of ICD-10 code 8 or 9 and were accompanied by wording "other" or "unspecified" or formulation of diseases which were not used in clinical practice and were absent in both guidelines issued by Russian or American professional societies. Despite existence of ICD rules the conducted analysis allows to state that those rules could be interpreted differently in various countries. This resulted in obtaining noncomparable data.Comparison of mortality rates in USA and Russia based on existing ICD coding rules cannot be correctly performed. Therefore, this comparison does not allow to assess contribution of financing and organization of medical service in differences in mortality rates between two countries.

Although excessive body mass and obesity are considered risk factors of a number of diseases and conditions numerous results of studies evidence for the existence of the "obesity paradox" - higher long-term survival of overweight and obese patients. Aim of this study was to elucidate impact of body mass index (BMI) on postoperative mortality and long-term survival of patients after coronary artery bypass grafting (CABG).The study was conducted on the basis of register of patients with ischemic heart disease who had undergone CABG with or without correction of valvular defects and/or resection of left ventricular (LV) aneurism during the period from 2000 to 2009 in the Chelyabinsk Interregional Cardiosurgical Center. Duration of follow-up was 1 to 10 years (mean - 2.3+/-2.4 years). The patients were divided into groups in dependence on BMI. Multifactorial logistic regression analysis of association of BMI and hospital mortality was carried out with adjustment for age, sex, arterial pressure, presence of diabetes mellitus (DM), chronic obstructive pulmonary disease, LV aneurism, LV ejection fraction, and character of involvement of vessels. Long term survival was studied using Coxs regression model.Compared with group of patients with normal BMI DM and arterial hypertension were more often registered among patients with excessive body mass and obesity. Elevated body mass was not an independent factor of risk of postoperative and lower long-term survival. There was a tendency to lower survival among patients with BMI35 rg/m2.Results of this study evidence for the absence of proof of negative impact of excessive BMI on hospital mortality and long term survival.