Critical analysis of death certificates issued by a public sector pediatric intensive care unit in Pakistan

Abstract

Background & objective: Accurate completion of Death Certificate (DC) is vital information of health statistics. Limited data is available on pediatric death certificates especially from Pakistan. The rationale of this study was to evaluate the accuracy and completeness of DC issued from a pediatric intensive care unit (PICU).

Methodology: A descriptive cross-sectional study was conducted in PICU of new public-sector pediatric in Karachi from January to June 2023. All deaths in children (1 month -15 years) occurred in PICU from medical illnesses and DCs were prepared by junior doctors. A total of 163 DCs were reviewed for major and minor errors in cause of death according to WHO international standards.

Results: Of 163 DCs, none were error-free. The total number of errors was 499 and mean number of errors was 3.06 per patient. The major errors were 306 and most common was mechanism of death reported as cardiopulmonary arrest as underlying cause of death (98.8%), minor errors were 193 and most common was the absence of time interval (100%).

Conclusion: Very high rate of errors was observed in death certificates from a pediatric intensive care unit. Educational interventions are urgently needed with follow-up study.

Abbreviations: COD: cause of death, DC: Death Certificate, MCCD: Medical Certificate of Cause of Death PICU: pediatric intensive care unit,

Keywords: Death certificate, Errors, Major and minor, Children, Cause of death

Citation: Faisal U, Noor M, Haque A. Critical analysis of death certificates issued by a public sector pediatric intensive care unit in Pakistan. Anaesth. pain intensive care 2025;29(9):1279-83. DOI: 10.35975/apic.v29i9.3065

Received: June 13, 2025; Revised: November 13, 2024; Accepted: December 23, 2025