Garbage codes as causes of death and quality of mortality statistics in Belo Horizonte, Brazil

Abstract Background Quality of cause-of-death information is fundamental for health planning. Traditionally, this quality has been assessed by the analysis of ill-defined causes from chapter XVIII of the International Classification of Diseases - 10th revision (ICD-10). However, studies have considered other useless diagnoses for public health purposes, defined, in conjunction with ill-defined causes, as garbage codes (GC). In Brazil, despite the high completeness of the Mortality Information System, approximately 30% of deaths are attributable to GCs. This study aims to analyze the frequency of GCs in Belo Horizonte municipality, the capital of Minas Gerais state, Brazil. Methods Data of deaths from 2011 to 2013 in Belo Horizonte were analyzed. GCs were classified according to the GBD 2015 study list. These codes were classified in: a) GCs from chapter XVIII of ICD-10 (GC-R), and b) GC from other chapters of ICD-10 (GC-nonR). Proportions of GC were calculated by sex, age, and place of occurrence. Results In Belo Horizonte, from the total of 44,123 deaths, 5.5% were classified as GC-R. The majority of GCs were GC-nonR (25% of total deaths). We observed a higher proportion of GC in children (1 to 4 years) and in people aged over 60 years. GC proportion was also higher in females, except in the age-groups under 1 year and 30-59 years. Home deaths (n = 7,760) had higher proportions of GCs compared with hospital deaths (n = 30,182), 36.9% and 28.7%, respectively. The leading GCs were the GC-R other ill-defined and unspecified causes of death (ICD-10 code R99)), and the GCs-nonR unspecified pneumonia (J18.9), unspecified stroke (I64), and unspecified septicemia (A41.9). Conclusions Analysis of GCs is essential to evaluate the quality of mortality information. Key messages Analysis of ill-defined causes (GC-R) is not sufficient to evaluate the quality of information on causes of death. Causes of death analysis should consider the total GC, in order to advance the discussion and promote adequate intervention on the quality of mortality statistics.

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Unknown and ill-defined causes of death in the mortality of the populations of Serbia, Croatia, North Macedonia, and Slovenia, in the period between 2007 and 2016

Srpski medicinski casopis Lekarske komore ◽

10.5937/smclk2-32461 ◽

2021 ◽

Vol 2 (2) ◽

pp. 23-32

Author(s):

Nataša Rosić

Keyword(s):

Cause Of Death ◽

Death Rate ◽

Causes Of Death ◽

Linear Trend ◽

International Classification Of Diseases ◽

Laboratory Findings ◽

Mortality Statistics ◽

Classification Of Diseases ◽

Health Situation

Introduction: Data on the cause of death form the cornerstone for analyzing the health situation and disease in countries, and they make a major contribution to building evidence for health policies. Aim: The aim of this study was to determine the extent to which diagnoses from the group - Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99), International Classification of Diseases (ICD - Revision X) were used as the main cause of death in Serbia, Croatia, North Macedonia, and Slovenia in the ten-year period, 2007 - 2016. Materials and methods: Methods of descriptive and analytical statistics were used in this research. An analysis of data on the causes of death (R00-R99 ICD - Revision X), by gender, during the ten-year period (2007 - 2016) was performed. Linear regression was also used as an analytical method to analyze the trend. Results: During the ten-year period, in Serbia, the R00-R99 diagnoses were among the five most common groups of diagnoses of death, i.e., in each year they took third place, with a percentage of 4.7%. In the observed period, in the surrounding countries, there was an increase in the death rate in Slovenia, with the highest rate in 2016 (19.9), while in Croatia there was a decrease in the death rate related to the diagnoses from group XVIII ICD - X (R00-R99). In Macedonia, the rate had a linear trend, with a slight decline in 2012 (52.3) and 2013 (58.7). In the observed period, an increase in the death rate of the population of Serbia with an unknown cause of death was observed, with particularly high rates in 2009 and 2016. Comparative analysis has shown that R00-R99 diagnoses are represented more in the mortality statistics of Serbia than in Slovenia and Croatia, and less than in Northern Macedonia. Conclusion: Urgent interventions are needed to improve the quality of mortality statistics and data on the causes of death in the described countries.

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Incidence of Football Injuries and Complaints in Different Age Groups and Skill-Level Groups

The American Journal of Sports Medicine ◽

10.1177/28.suppl_5.s-51 ◽

2000 ◽

Vol 28 (5_suppl) ◽

pp. 51-57 ◽

Cited By ~ 193

Author(s):

Lars Peterson ◽

Astrid Junge ◽

Jiri Chomiak ◽

Toni Graf-Baumann ◽

Jiri Dvorak

Keyword(s):

Continuing Education ◽

Age Groups ◽

International Classification Of Diseases ◽

Fair Play ◽

Skill Levels ◽

Subsequent Performance ◽

Classification Of Diseases ◽

Icd 10 ◽

Over Time

In this study, the incidence of football injuries and complaints as related to different age groups and skill levels was studied over the period of 1 year. All injuries and complaints as well as the amount of time players spent in training and games were recorded. All injured players were examined weekly by physicians, and all injuries were assessed according to the International Classification of Diseases (ICD-10), which describes them in terms of injury type and location, the treatment required, and the duration of subsequent performance limitations. A total of 264 players of different age groups and skill levels was observed for 1 year. Five hundred fifty-eight injuries were documented. Two hundred sixteen players had one or more injuries. Only 48 players (18%) had no injury. The average number of injuries per player per year was 2.1. Injuries were classified as mild (52%), moderate (33%), or severe (15%). Almost 50% of all injuries were contact injuries; half of all the contact injuries were associated with foul play. The majority of injuries were strains and sprains involving the ankle, knee, and lumbar spine. Nearly all players (91%) suffered from complaints related to football. Only 23 players reported no injuries and no complaints. Prevention programs, fair play, and continuing education in techniques and skills may reduce the incidence of injuries over time.

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La reconstrucción de las causas de muerte por el método MODICOD en el análisis demográfico-sanitario. De la CIE-9 a la CIE-10 a un nivel de cuarto dígito

Empiria Revista de metodología de ciencias sociales ◽

10.5944/empiria.40.2018.22015 ◽

2018 ◽

pp. 167

Author(s):

Aina Faus-Bertomeu ◽

Rosa Gómez-Redondo

Keyword(s):

Causes Of Death ◽

International Classification Of Diseases ◽

Epidemiological Transition ◽

Health Transition ◽

Fourth Digit ◽

Classification Of Diseases ◽

Icd 10 ◽

La Red ◽

First Time

A pesar del conocimiento acumulado sobre mortalidad y longevidad se hace imprescindible conocer con mayor profundidad la cuarta fase de la Transición Epidemiológica en la que se encuentra España, como otros países de su entorno, para anticipar la emergencia de un nuevo escalón en la Transición Sanitaria así como su impacto social en los años venideros. Para ello, se precisa del análisis de datos de mortalidad por causas de muerte con el objeto de seguir su evolución y cambios. No obstante la codificación de las causas de muerte se interrumpe con las sucesivas revisiones a la Clasificación Internacional de Enfermedades (CIE). Por ello, se utiliza la metodología de la reconstrucción de causas de muerte propuesta por France Meslé y Jacques Vallin (1988, 1996), de aplicación en la comunidad científica de los países que forman parte de la red internacional Mortality, Divergence and Causes of Death (MODICOD) y en la que las autoras participan en representación de España. El presente trabajo describe las fases de dicho protocolo y lo ejemplifica con los datos de causas de muerte españolas para el periodo 1980- 2012, reconstruyendo las series entre la CIE-9 y la CIE-10. Los resultados obtenidos garantizan el seguimiento de 6.902 rúbricas de causas de muerte continuas y homogeneizadas que por primera vez se establece a nivel de desagregación del cuarto dígito de la CIE-10 configurándose como un instrumento metodológico en el análisis demográfico-epidemiológico.Despite the accumulated knowledge about mortality and longevity, it is essential to know in the depth of the fourth phase of the Epidemiological Transition in which Spain, like other neighboring countries, is in to anticipate a new step in the Health Transition as well as its impact in the coming years. In this context, the analysis of the data of the causes of death is necessary in order to follow its evolution and changes. However, the codification of causes of death is interrupted by the successive revisions to the International Classification of Diseases and Related Health Problems (ICD). For this reason, the methodology of the reconstruction of causes of death proposed by France Meslé and Jacques Vallin (1988, 1996) is used and applied in the countries that are part of the international network Mortality, Divergence and Causes of Death (MODICOD) and in which the authors participate in representation of Spain. The present work describes the phases of this protocol and exemplifies it with the date of Spanish causes of death for the period 1980 to 2015, reconstructing series between ICD-9 and ICD-10. The results obtained ensuring the monitoring of 6,902 rubrics of continuous and homogenized causes of death at a fourth digit level of the ICD-10, which for the first time is established at a level of the fourth digit of the ICD-10, that are configured as a demographic-epidemiological methodological instrument.

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Antimicrobial Prescription Practices for Outpatients with Cystitis: A Multicenter, Medical Record-Based Study

10.21203/rs.3.rs-1132930/v1 ◽

2021 ◽

Author(s):

Misa Takahashi ◽

Hideharu Hagiya ◽

Tsukasa Higashionna ◽

Yasuhiro Nakano ◽

Kota Sato ◽

...

Keyword(s):

Broad Spectrum ◽

Age Groups ◽

Antibiotic Use ◽

International Classification Of Diseases ◽

Prescription Practices ◽

Classification Of Diseases ◽

Icd 10 ◽

Prescription Rates ◽

Uncomplicated Cystitis ◽

Antimicrobial Prescription

Abstract To promote antimicrobial stewardship (AMS) and appropriate antibiotic use, we studied antimicrobial prescription rates for uncomplicated cystitis, a common outpatient disease requiring antibiotic treatment in Japan. This multicenter retrospective study was performed from January 1, 2018, to December 31, 2020, targeting outpatients aged ≥20 years whose medical records revealed International Classification of Diseases (ICD-10) codes suggesting uncomplicated cystitis (N300). We divided eligible cases into two age groups (20–49 years and ≥50 years) and defined broad-spectrum antimicrobials as fluoroquinolones, third-generation cephalosporins, and faropenem. Primary and secondary outcomes were defined as the prescription rates of broad-spectrum antimicrobials for the disease and the association of antimicrobial types with recurrence. The data of 1,445 patients were collected and that of 902 patients were analyzed. The overall proportion of broad-spectrum antimicrobial prescriptions was 69.1%. The broad-spectrum agents were prescribed frequently in the older group, male patients, and internal medicine. Recurrence was observed in 37 (4.1%) cases, and age, sex, or antimicrobial types were not associated with the recurrence. Hence, approximately two-thirds of antimicrobials prescribed for uncomplicated cystitis were broad-spectrum agents. Administration of broad-spectrum antimicrobials was not associated with the prevention of the recurrence of cystitis.

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The Milano Sforza Registers

10.1101/2021.02.10.20249093 ◽

2021 ◽

Author(s):

Elia Biganzoli ◽

Folco Vaglienti ◽

Patrizia Boracchi ◽

Ester Luconi ◽

Silvana Castaldi ◽

...

Keyword(s):

Causes Of Death ◽

Social Ties ◽

International Classification Of Diseases ◽

Individual Responsibility ◽

Database Application ◽

The Social ◽

Classification Of Diseases ◽

Icd 10 ◽

Original Classification

AbstractThe Mortorum Libri of Milano (1452-1801) represent the first register in Europe based on the daily recording of the dead and detailed information about the social ties of decease people.Mortorum Libri’s protocol is the first example of a monitoring and prevention chain based on ethical and juridical individual responsibility.The causes of death were codified according to the International Classification of Diseases (ICD-10) to relate the original classification with the present one.This study has a particular reference to the Registers of the 15th century and analyzes the mortality in 1480 as an example of the database application in epidemiology.

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Depressive, anxious and somatization symptoms and quality of life in stress-related disorders

Vojnosanitetski pregled ◽

10.2298/vsp150604263c ◽

2017 ◽

Vol 74 (10) ◽

pp. 927-931

Author(s):

Olga Colovic ◽

Dusica Lecic-Tosevski ◽

Vanja Mandic-Maravic ◽

Oliver Toskovic

Keyword(s):

Quality Of Life ◽

Depressive Symptoms ◽

International Classification Of Diseases ◽

Therapeutic Interventions ◽

Post Traumatic Stress ◽

Related Disorder ◽

Quality Of Life Scale ◽

Classification Of Diseases ◽

Icd 10

Background/Aim. Recent studies have shown a significant relation of the post-traumatic stress disorder and impairment of quality of life. The research on the relations of other stress-related disorders and quality of life is scarce. The aim of this re-search was to determine which symptoms within the stress-related disorders (depressive, anxious and somatization) have the strongest effect on the quality of life decrease. Methods. The study group comprised 80 subjects who have developed a certain stress-related disorder. The diagnosis was made based on the International Classification of Diseases (ICD-10) criteria. Manchester Short Assessment Quality of Life Scale (MANSA) and Symptom Check List-90 Revised (SCL-90-R) were administered. Results. The presence of all three types of symptoms (depressive, anxious or somatization) was in negative correlation with the quality of life, contributing to the variation of quality of life with 40%. Depressive symptoms had the greatest impact on the quality of life impairment. Conclusion. When it comes to stress-related disorders, the quality of life is mostly impaired by depressive symptoms. Target therapeutic interventions aimed at depressive symptoms might have a significant effect on the quality of life improvement in the person who developed stress-related disorders.

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Using a retrospective cross-sectional study to analyse unintentional fatal drowning in Australia: ICD-10 coding-based methodologies verses actual deaths

BMJ Open ◽

10.1136/bmjopen-2017-019407 ◽

2017 ◽

Vol 7 (12) ◽

pp. e019407 ◽

Cited By ~ 26

Author(s):

Amy E Peden ◽

Richard C Franklin ◽

Alison J Mahony ◽

Justin Scarr ◽

Paul D Barnsley

Keyword(s):

Causes Of Death ◽

International Classification Of Diseases ◽

Cross Sectional Study ◽

Cross Sectional ◽

Life Saving ◽

Classification Of Diseases ◽

Icd 10 ◽

Underlying Causes ◽

Icd Codes ◽

Underlying Cause Of Death

ObjectivesFatal drowning estimates using a single underlying cause of death (UCoD) may under-represent the number of drowning deaths. This study explores how data vary by International Classification of Diseases (ICD)-10 coding combinations and the use of multiple underlying causes of death using a national register of drowning deaths.DesignAn analysis of ICD-10 external cause codes of unintentional drowning deaths for the period 2007–2011 as extracted from an Australian total population unintentional drowning database developed by Royal Life Saving Society—Australia (the Database). The study analysed results against three reporting methodologies: primary drowning codes (W65-74), drowning-related codes, plus cases where drowning was identified but not the UCoD.SettingAustralia, 2007–2011.ParticipantsUnintentional fatal drowning cases.ResultsThe Database recorded 1428 drowning deaths. 866 (60.6%) had an UCoD of W65-74 (accidental drowning), 249 (17.2%) cases had an UCoD of either T75.1 (0.2%), V90 (5.5%), V92 (3.5%), X38 (2.4%) or Y21 (5.9%) and 53 (3.7%) lacked ICD coding. Children (aged 0–17 years) were closely aligned (73.9%); however, watercraft (29.2%) and non-aquatic transport (13.0%) were not. When the UCoD and all subsequent causes are used, 67.2% of cases include W65-74 codes. 91.6% of all cases had a drowning code (T75.1, V90, V92, W65-74, X38 and Y21) at any level.ConclusionDefining drowning with the codes W65-74 and using only the UCoD captures 61% of all drowning deaths in Australia. This is unevenly distributed with adults, watercraft and non-aquatic transport-related drowning deaths under-represented. Using a wider inclusion of ICD codes, which are drowning-related and multiple causes of death minimises this under-representation. A narrow approach to counting drowning deaths will negatively impact the design of policy, advocacy and programme planning for prevention.

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Ill-defined causes of death in Brazil: a redistribution method based on the investigation of such causes

Revista de Saúde Pública ◽

10.1590/s0034-8910.2014048005146 ◽

2014 ◽

Vol 48 (4) ◽

pp. 671-681 ◽

Cited By ~ 34

Author(s):

Elisabeth França ◽

Renato Teixeira ◽

Lenice Ishitani ◽

Bruce Bartholow Duncan ◽

Juan José Cortez-Escalante ◽

...

Keyword(s):

Causes Of Death ◽

International Classification Of Diseases ◽

Endocrine Diseases ◽

Original Distribution ◽

Classification Of Diseases ◽

Icd 10 ◽

Similar Factor ◽

External Causes ◽

Proportional Distribution

OBJECTIVE To propose a method of redistributing ill-defined causes of death (IDCD) based on the investigation of such causes.METHODS In 2010, an evaluation of the results of investigating the causes of death classified as IDCD in accordance with chapter 18 of the International Classification of Diseases (ICD-10) by the Mortality Information System was performed. The redistribution coefficients were calculated according to the proportional distribution of ill-defined causes reclassified after investigation in any chapter of the ICD-10, except for chapter 18, and used to redistribute the ill-defined causes not investigated and remaining by sex and age. The IDCD redistribution coefficient was compared with two usual methods of redistribution: a) Total redistribution coefficient, based on the proportional distribution of all the defined causes originally notified and b) Non-external redistribution coefficient, similar to the previous, but excluding external causes.RESULTS Of the 97,314 deaths by ill-defined causes reported in 2010, 30.3% were investigated, and 65.5% of those were reclassified as defined causes after the investigation. Endocrine diseases, mental disorders, and maternal causes had a higher representation among the reclassified ill-defined causes, contrary to infectious diseases, neoplasms, and genitourinary diseases, with higher proportions among the defined causes reported. External causes represented 9.3% of the ill-defined causes reclassified. The correction of mortality rates by the total redistribution coefficient and non-external redistribution coefficient increased the magnitude of the rates by a relatively similar factor for most causes, contrary to the IDCD redistribution coefficient that corrected the different causes of death with differentiated weights.CONCLUSIONS The proportional distribution of causes among the ill-defined causes reclassified after investigation was not similar to the original distribution of defined causes. Therefore, the redistribution of the remaining ill-defined causes based on the investigation allows for more appropriate estimates of the mortality risk due to specific causes.

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Investigation of hospital deaths declared as garbage codes in Belo Horizonte, Brazil, in 2017

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.050 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

P Corrêa ◽

L Ishitani ◽

S Lansky ◽

M Santos ◽

R Teixeira ◽

...

Keyword(s):

Public Health ◽

Causes Of Death ◽

Heart Diseases ◽

Mortality Data ◽

Chronic Obstructive ◽

Mortality Statistics ◽

Obstructive Pulmonary Disease ◽

Belo Horizonte ◽

The Impact

Abstract Background Improving the quality of causes of death (COD) is vital for defining adequate public policies. In Brazil, one third of deaths are reported as having a cause that is not useful for public health analysis of cause-of-death data, the so-called garbage codes (GC). The investigation of these deaths is one of the strategies that could improve the quality of mortality statistics in the country. Methods For all GCs identified in 2017 in the routine mortality information system from Belo Horizonte city, Brazil, municipal health professionals collected information about the final disease obtained from hospital records or autopsies in a standardized form. A trained physician analyzed this information and filled in a new death certificate (DC). The DC that originally showed a GC as an underlying COD was categorized into GC reclassified when the garbage cause changed to a specific cause after investigation. Causes of death derived from the reclassified GCs were analyzed to assess the impact on the mortality profile before and after the investigation. Results In Belo Horizonte, 1,395 deaths out of 3,038 registered as garbage codes were investigated, with a 35% reduction in deaths due to these causes. There was an increase in deaths from ischemic heart diseases, Alzheimer's disease, chronic obstructive pulmonary disease, hemorrhagic and ischemic stroke, and violence. Conclusions The investigation of deaths from garbage codes modified the mortality profile and improved its quality, providing direction for more assertive public health policies. Strategies for training physicians to report specific causes of death is another strategy that could improve the quality of mortality data. Key messages This study proved to be a feasible strategy in improving the quality of causes of death in mortality statistics and should be incorporated into the surveillance routine activities in Brazil. The evaluation of the GC investigation is an important instrument in helping management of health interventions aiming at better quality of information and more qualified health services.

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896Quantifying cause-related mortality incorporating multiple causes: challenges and opportunities

International Journal of Epidemiology ◽

10.1093/ije/dyab168.327 ◽

2021 ◽

Vol 50 (Supplement_1) ◽

Author(s):

Grace Joshy ◽

James Eynstone-Hinkins ◽

Lauren Moran ◽

Saliu Balogun ◽

Karen Bishop ◽

...

Keyword(s):

Statistical Methods ◽

Causes Of Death ◽

International Classification Of Diseases ◽

International Classification ◽

Mortality Data ◽

Mortality Statistics ◽

Challenges And Opportunities ◽

Classification Of Diseases ◽

Multiple Causes

Abstract Key contact person Dr Grace Joshy, Fellow, Research School of Population Health, Australian National University. Focus and outcomes for participants Mortality statistics are typically based on a single underlying cause of death (UCoD), derived from multiple conditions on the death certificate, and have provided critical evidence for policy and practice for over a century. There have been radical shifts in patterns of death in the past couple of decades; deaths in older ages are increasingly from chronic and degenerative diseases. The relevance of assuming that a single disease is causing the death is diminishing, especially with an aging population structure and increasing life expectancy. This symposium will enable participants to understand the complexities associated with mortality reporting/coding, strengths and limitations of available statistical methods for using multiple causes of death (MCoD) and the importance of quantifying mortality incorporating MCoD. Rationale for the symposium, including for its inclusion in the Congress The use of a single UCoD rather than MCoD means that vast amounts of potentially useful data are largely ignored, which is likely to bias mortality estimates (including under- and over-reporting of the importance of certain causes of death). Despite global recognition of the urgent need to better integrate data on MCoD into mortality statistics, use of these data are challenging and limited. Complexities arise from the way mortality information is reported on death certificates and coded to form mortality collections; limited understanding of available statistical methods also adds to the complexity. International Classification of Diseases 10th Revision (ICD-10) has been translated into 43 languages and it is being used by over 100 countries to report mortality data, a primary indicator of health status. The 2018 release of the 11th revision of the International Classification of Diseases, enriching data on multiple parameters including comorbidity, confers further urgency and a unique opportunity to optimise the use of MCoD in mortality reporting. The World Congress of Epidemiology 2020 will provide a unique platform for wider discussions on the challenges and opportunities for using MCoD data. The symposium will provide a deeper understanding and enhanced the use of MCoD data. The speakers are engaged in cutting-edge NHMRC-funded research on mortality incorporating MCoD and development of novel statistical methods. Presentation program The symposium will feature presentations from six speakers. Names of presenters James Eynstone-Hinkins, Lauren Moran, Saliu Balogun, Karen Bishop, Margarita Moreno-Betancur, Grace Joshy

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