НЕКОТОРЫЕ ОРГАНИЗАЦИОННЫЕ ФАКТОРЫ НЕБЛАГОПРИЯТНЫХ ИСХОДОВ БОЛЕЗНЕЙ СИСТЕМЫ КРОВООБРАЩЕНИЯ В ПЕРИОД ПАНДЕМИИ НОВОЙ КОРОНАВИРУСНОЙ ИНФЕКЦИИ

Abstract

From 2019 to 2020, the Kemerovo region – Kuzbass region, as the Russian Federation, registered a 22.9% increase in the number of deaths from diseases of the circulatory system in the total number of deaths. Undoubtedly, the current epidemiological situation had a negative impact on the increase in mortality from diseases of the circularity system. Preventive services and regular medical examinations during the pandemic of a new coronavirus infection have been significantly reduced or discontinued, and therefore, the problem of quality of examination of people with diseases of the circulatory system has acquired a particular importance. The purpose of the study was to assess quality of regular medical examination of patients who died at home from acute and chronic forms of diseases of the circulatory system. Material and methods. The authors have analyzed 254 medical death certificates, selected in the territories of the Kemerovo region - Kuzbass region with high rates of cardiovascular mortality. Data were analyzed to identify age and nosological structure of mortality from diseases of the circulatory system. To evaluate quality of regular medical examination the territories were requested to submit the forms N 025/y and N 030/y. The number of cases provided equaled to 56 out of 254 requested, representing 22% of the study sample. Descriptive statistics methods were used for statistical data processing. Results. Chronic forms of diseases of the circulatory system were detected in 209 (82.3%) cases, while acute - in 45 (17.7%). The age of study sample ranged from 33 to 98 years, median 74.5 (65; 85) years. The sample was rather dominated by women than men - 141 (55.5%) versus 113 (44.5%). More deaths from acute forms of diseases of the circulatory system were registered in the age group of 60-74 years, while more deaths from chronic forms - in the age group of 75-90 years. Analysis of the forms N 025/y and N 030/y (n=56) showed that 36 people (64.3%) visited a doctor at least once during the year before death. Patients were not fully examined: total cholesterol was determined in 16 patients (44.4%), while low-density lipoproteins were assessed in only 3 patients (8.3%), electrocardiogram was performed in 13 patients (36.1%), while echocardiography - in 6 patients (16.7%). Consultation with cardiologist was provided to 4 patients (11.1%). Control over health indicators showed that achievement of the target levels of blood pressure in people with hypertension was registered in 43.3% of cases (13 out of 30), control over total cholesterol in people with coronary heart disease was managed in 20% of cases (4 out of 20). Conclusion. Regular medical examination of patients with diseases of the circulatory system was not fully implemented during the pandemic that could possibly account for a low availability of specialized medical care, which should be regarded as a factor of poor outcomes of diseases of the circulatory system.