Deaths with Dementia in Indigenous and Non-Indigenous Australians: A Nationwide Study

2021 ◽  
pp. 1-11
Author(s):  
Michael Waller ◽  
Rachel F. Buckley ◽  
Colin L. Masters ◽  
Francis R. Nona ◽  
Sandra Eades ◽  
...  
Keyword(s):  
Death Certificate ◽  
Relative Rate ◽  
Population Level ◽  
International Classification Of Diseases ◽  
Mortality Data ◽  
Indigenous Australians ◽  
Indigenous Status ◽  
Indigenous Group ◽  
Classification Of Diseases ◽  
Underlying Cause Of Death

Background: The prevalence of dementia is generally reported to be higher among Indigenous peoples. Objective: The rates and coding of dementia mortality were compared between Indigenous and non-Indigenous Australians. Methods: De-identified individual records on causes of death for all people aged 40 years or more who died in Australia between 2006 and 2014 (n = 1,233,084) were used. There were 185,237 records with International Classification of Diseases, Tenth Revision, codes for dementia (Alzheimer’s Disease, vascular dementia, or unspecified dementia) as the underlying cause of death or mentioned elsewhere on the death certificate. Death rates were compared using Poisson regression. Logistic regression was used to assess whether dementia was more likely to be classified as ‘unspecified’ type in Indigenous Australians. Results: The rates of death with dementia were 57% higher in Indigenous Australians, compared to non-Indigenous, relative rate (RR) 1.57, 95% confidence interval (CI) (1.48, 1.66), p <  0.0001. This excess of deaths was highest at ages below 75 (RRs >  2, test for interaction p <  0.0001), and among men (test for interaction p <  0.0001). When the underreporting of Indigenous status on the death certificate was taken into account the relative rate increased to 2.17, 95% CI (2.07, 2.29). Indigenous Australians were also more likely to have their dementia coded as ‘unspecified’ on their death certificate (Odds Ratio 1.92, 95% CI (1.66, 2.21), p <  0.0001), compared to the non-Indigenous group. Conclusion: This epidemiological analysis based on population level mortality data demonstrates the higher dementia-related mortality rate for Indigenous Australians especially at younger ages.

scholarly journals Modern Look at Transverse Myelitis and Inflammatory Myelopathy

2021 ◽  
Vol 8 (6) ◽  
pp. e1071
Author(s):  
Justin R. Abbatemarco ◽  
Jonathan R. Galli ◽  
Michael L. Sweeney ◽  
Noel G. Carlson ◽  
Verena C. Samara ◽  
...  
Keyword(s):  
Transverse Myelitis ◽  
Population Level ◽  
International Classification Of Diseases ◽  
Mortality Data ◽  
Veterans Health ◽  
Health Administration ◽  
Level Data ◽  
High Prevalence ◽  
Classification Of Diseases

Background and ObjectivesTo characterize population-level data associated with transverse myelitis (TM) within the US Veterans Health Administration (VHA).MethodsThis retrospective review used VHA electronic medical record from 1999 to 2015. We analyzed prevalence, disease characteristics, modified Rankin Scale (mRS) scores, and mortality data in patients with TM based on the 2002 Diagnostic Criteria.ResultsWe identified 4,084 patients with an International Classification of Diseases (ICD) code consistent with TM and confirmed the diagnosis in 1,001 individuals (90.7% males, median age 64.2, 67.7% Caucasian, and 31.4% smokers). The point prevalence was 7.86 cases per 100,000 people. Less than half of the cohort underwent a lumbar puncture, whereas only 31.8% had a final, disease-associated TM diagnosis. The median mRS score at symptom onset was 3 (interquartile range 2–4), which remained unchanged at follow-up, although less than half (43.2%) of the patients received corticosteroids, IVIg, or plasma exchange. Approximately one-quarter of patients (24.3%) had longitudinal extensive TM, which was associated with poorer outcomes (p = 0.002). A total of 108 patients (10.8%) died during our review (94.4% males, median age 66.5%, and 70.4% Caucasian). Mortality was associated with a higher mRS score at follow-up (OR 1.94, 95% CI, 1.57–2.40) and tobacco use (OR 1.87, 95% CI, 1.17–2.99).DiscussionThis national TM review highlights the relatively high prevalence of TM in a modern cohort. It also underscores the importance of a precise and thorough workup in this disabling disorder to ensure diagnostic precision and ensure optimal management for patients with TM in the future.

Children's Deaths at Day-Care Facilities

PEDIATRICS ◽  
1994 ◽  
Vol 94 (6) ◽  
pp. 1039-1041
Author(s):  
Susan E. E. Good ◽  
R. Gibson Parrish ◽  
Roy T. Ing
Keyword(s):  
Day Care ◽  
International Classification Of Diseases ◽  
International Classification ◽  
Mortality Data ◽  
Care Facilities ◽  
Classification Of Diseases ◽  
State And Local ◽  
Death Investigation ◽  
Medical Examiners

In the US, there is no mechanism readily available to identify children who die while attending day care. The National Center for Health Statistics (NCHS) uses the International Classification of Diseases 9th Edition (ICD-9) to categorize US mortality data; however, the International Classification of Diseases does not contain a category for "day care" as the place of death. Thus, researchers using NCHS mortality data are unable to count day-care deaths on a national basis. To identify children who died while in day care, it is necessary to review the records of those who investigated the deaths. In most counties and states, medical examiners or coroners (ME/C) are responsible for investigating unusual and sudden deaths. Their records often contain detailed information on the place and circumstances of death. The Medical Examiners and Coroners Information Sharing Programs (MECISP) at the Centers for Disease Control and Prevention (CDC) works with state and local medical examiners and coroners to improve the availability of data on deaths that they investigate. Computerized data are gathered on all deaths investigated by participating ME/C offices; data are obtained from six state and seven county jurisdictions. These jurisdictions have a combined population of 37 million people and record 56 000 deaths per year. Of these jurisdictions, one state and three county offices have text within their computerized data that describes the circumstances, place, and cause of each death. The objective of our study was to demonstrate the usefulness of ME/C death-investigation records as a means of identifying and characterizing the types of deaths that occur among children while attending day care facilities.

scholarly journals Mortality Due to Cystic Fibrosis over a 36-Year Period in Spain: Time Trends and Geographic Variations

2019 ◽  
Vol 16 (1) ◽  
pp. 119 ◽  
Author(s):  
Ana Villaverde-Hueso ◽  
Germán Sánchez-Díaz ◽  
Francisco J. Molina-Cabrero ◽  
Elisa Gallego ◽  
Manuel Posada de la Paz ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Time Trends ◽  
Health Planning ◽  
International Classification Of Diseases ◽  
Mortality Rates ◽  
Population Based ◽  
Mediterranean Coast ◽  
Geographic Variations ◽  
Classification Of Diseases ◽  
Underlying Cause Of Death

The aim of this study is to analyze population-based mortality attributed to cystic fibrosis (CF) over 36 years in Spain. CF deaths were obtained from the National Statistics Institute, using codes 277.0 from the International Classification of Diseases (ICD) ninth revision (ICD9-CM) and E84 from the tenth revision (ICD10) to determine the underlying cause of death. We calculated age-specific and age-adjusted mortality rates, and time trends were assessed using joinpoint regression. The geographic analysis by district was performed by standardized mortality ratios (SMRs) and smoothed-SMRs. A total of 1002 deaths due to CF were identified (50.5% women). Age-adjusted mortality rates fell by −0.95% per year between 1981 and 2016. The average age of death from CF increased due to the annual fall in the mortality of under-25s (−3.77% males, −2.37% females) and an increase in over-75s (3.49%). We identified districts with higher than expected death risks in the south (Andalusia), the Mediterranean coast (Murcia, Valencia, Catalonia), the West (Extremadura), and the Canary Islands. In conclusion, in this study we monitored the population-based mortality attributed to CF over a long period and found geographic differences in the risk of dying from this disease. These findings complement the information provided in other studies and registries and will be useful for health planning.

scholarly journals The impact of errors in medical certification on the accuracy of the underlying cause of death

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0259667
Author(s):  
U. S. H. Gamage ◽  
Tim Adair ◽  
Lene Mikkelsen ◽  
Pasyodun Koralage Buddhika Mahesh ◽  
John Hart ◽  
...  
Keyword(s):  
Cause Of Death ◽  
Death Certificate ◽  
International Classification Of Diseases ◽  
High Impact ◽  
Error Type ◽  
Medical Certification ◽  
Underlying Cause Of Death ◽  
The Impact ◽  
Very High ◽  
Death Data

Background Correct certification of cause of death by physicians (i.e. completing the medical certificate of cause of death or MCCOD) and correct coding according to International Classification of Diseases (ICD) rules are essential to produce quality mortality statistics to inform health policy. Despite clear guidelines, errors in medical certification are common. This study objectively measures the impact of different medical certification errors upon the selection of the underlying cause of death. Methods A sample of 1592 error-free MCCODs were selected from the 2017 United States multiple cause of death data. The ten most common types of errors in completing the MCCOD (according to published studies) were individually simulated on the error-free MCCODs. After each simulation, the MCCODs were coded using Iris automated mortality coding software. Chance-corrected concordance (CCC) was used to measure the impact of certification errors on the underlying cause of death. Weights for each error type and Socio-demographic Index (SDI) group (representing different mortality conditions) were calculated from the CCC and categorised (very high, high, medium and low) to describe their effect on cause of death accuracy. Findings The only very high impact error type was reporting an ill-defined condition as the underlying cause of death. High impact errors were found to be reporting competing causes in Part 1 [of the death certificate] and illegibility, with medium impact errors being reporting underlying cause in Part 2 [of the death certificate], incorrect or absent time intervals and reporting contributory causes in Part 1, and low impact errors comprising multiple causes per line and incorrect sequence. There was only small difference in error importance between SDI groups. Conclusions Reporting an ill-defined condition as the underlying cause of death can seriously affect the coding outcome, while other certification errors were mitigated through the correct application of mortality coding rules. Training of physicians in not reporting ill-defined conditions on the MCCOD and mortality coders in correct coding practices and using Iris should be important components of national strategies to improve cause of death data quality.

scholarly journals The Role of COVID-19 in the Death of SARS-CoV-2–Positive Patients: A Study Based on Death Certificates

2020 ◽  
Vol 9 (11) ◽  
pp. 3459 ◽  
Author(s):  
Francesco Grippo ◽  
Simone Navarra ◽  
Chiara Orsi ◽  
Valerio Manno ◽  
Enrico Grande ◽  
...  
Keyword(s):  
Heart Disease ◽  
Cause Of Death ◽  
Hypertensive Heart Disease ◽  
International Classification Of Diseases ◽  
Death Certificates ◽  
Respiratory Complications ◽  
Classification Of Diseases ◽  
Underlying Cause Of Death ◽  
And Gender ◽  
Low Prevalence

Background: Death certificates are considered the most reliable source of information to compare cause-specific mortality across countries. The aim of the present study was to examine death certificates of persons who tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to (a) quantify the number of deaths directly caused by coronavirus 2019 (COVID-19); (b) estimate the most common complications leading to death; and (c) identify the most common comorbidities. Methods: Death certificates of persons who tested positive for SARS-CoV-2 provided to the National Surveillance system were coded according to the 10th edition of the International Classification of Diseases. Deaths due to COVID-19 were defined as those in which COVID-19 was the underlying cause of death. Complications were defined as those conditions reported as originating from COVID-19, and comorbidities were conditions independent of COVID-19. Results: A total of 5311 death certificates of persons dying in March through May 2020 were analysed (16.7% of total deaths). COVID-19 was the underlying cause of death in 88% of cases. Pneumonia and respiratory failure were the most common complications, being identified in 78% and 54% of certificates, respectively. Other complications, including shock, respiratory distress and pulmonary oedema, and heart complications demonstrated a low prevalence, but they were more commonly observed in the 30–59 years age group. Comorbidities were reported in 72% of certificates, with little variation by age and gender. The most common comorbidities were hypertensive heart disease, diabetes, ischaemic heart disease, and neoplasms. Neoplasms and obesity were the main comorbidities among younger people. Discussion: In most persons dying after testing positive for SARS-CoV-2, COVID-19 was the cause directly leading to death. In a large proportion of death certificates, no comorbidities were reported, suggesting that this condition can be fatal in healthy persons. Respiratory complications were common, but non-respiratory complications were also observed.

scholarly journals Effect of A Randomized trial of Unruptured Brain Arteriovenous Malformation on Interventional Treatment Rates for Unruptured Arteriovenous Malformations

2019 ◽  
Vol 47 (5-6) ◽  
pp. 299-302 ◽  
Author(s):  
Alexandra S. Reynolds ◽  
Monica L. Chen ◽  
Alexander E. Merkler ◽  
Abhinaba Chatterjee ◽  
Iván Díaz ◽  
...  
Keyword(s):  
Randomized Trial ◽  
Arteriovenous Malformations ◽  
Population Level ◽  
International Classification Of Diseases ◽  
Interventional Treatment ◽  
Classification Of Diseases ◽  
Nationally Representative ◽  
Brain Avms ◽  
Join Point ◽  
Procedure Codes

Background: In 2013, investigators from A Randomized Trial of Unruptured Brain Arteriovenous Malformations (AVM; ARUBA) reported that interventions to obliterate unruptured AVMs caused more morbidity and mortality than medical management. Objective: We sought to determine whether interventions for unruptured AVM decreased after publication of ARUBA results. Methods: We used the Nationwide Readmissions Database to assess trends in interventional AVM management in patients ≥18 years of age from 2010 through 2015. Unruptured brain AVMs were identified using International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) code 747.81 and excluding any patient with a diagnosis of intracranial hemorrhage. Our primary outcome was interventional AVM treatment, identified using ICD-9-CM procedure codes for surgical resection, endovascular therapy, and stereotactic radiosurgery. Join-point regression was used to assess trends in the incidence of interventional AVM management among adults from 2010 through 2015. Results: There was no significant U.S. population level change in unruptured brain AVM intervention rates before versus after ARUBA (p = 0.59), with the incidence of AVM intervention ranging from 8.0 to 9.2 per 10 million U.S. residents before the trial publication to 7.7–8.3 per 10 million afterwards. Conclusions: In a nationally representative sample, we found no change in rates of interventional unruptured AVM management after publication of the ARUBA trial results.

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

BMJ Open ◽  
2017 ◽  
Vol 7 (12) ◽  
pp. e019407 ◽  
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.

Abstract P096: Trends in Heart Disease Mortality Among Mississippi Adults Over a Three Decade Period, 1980 Through 2013

Circulation ◽  
2016 ◽  
Vol 133 (suppl_1) ◽  
Author(s):  
Vincent L. Mendy ◽  
Rodolfo Vargas ◽  
Lamees El-sadek ◽  
Abigail Gamble
Keyword(s):  
Heart Disease ◽  
Cause Of Death ◽  
International Classification Of Diseases ◽  
Mortality Rates ◽  
Vital Statistics ◽  
Annual Percent Change ◽  
Percent Change ◽  
Classification Of Diseases ◽  
Icd 10 ◽  
Underlying Cause Of Death

Background: Heart disease (HD) mortality has declined in Mississippi over recent decades however it remains as the leading cause of death among Mississippians. Trends in Mississippi HD mortality have not been thoroughly explored. This study examined trends in HD mortality from 1980 through 2013 among Mississippi adults (≥ 25 years) and further assessed trends by race and sex. Methods and Results: Data from Mississippi Vital Statistics (1980 through 2013) were used to calculate age-specific HD mortality rates for Mississippi adults. Cases were identified using underlying cause of death codes from the International Classification of Diseases, Tenth Revision (ICD-10), including I00-I09, I11, I13, and I20-I51. Joinpoint software was used to calculate the average annual percent change in HD mortality rates for the overall population and by race, sex, and race and sex. Overall, the age-adjusted HD mortality rates among Mississippi adults decreased by 36.5% between 1980 and 2013 with an average annual percent change of -1.60% (95% CI -2.0 to -1.3). During this period, HD mortality rates decreased annually on average by -1.30% (95% CI -1.98 to -0.69) for black adults; by -1.60% (95% CI -1.74 to -1.46) for white adults; by -1.30% (95% CI -1.5 to -1.1) for all females, and by -1.90% (95% -2.2 to -1.5) for all males. Conclusions: Between 1980 and 2013 a continual decrease in HD mortality among Mississippi adults was observed. Disparities in the magnitude of the decrease in HD mortality existed by race and sex.

scholarly journals Improving the accuracy of ICD-10 coding of morbidity/mortality data through the introduction of an electronic diagnostic terminology tool at the general hospitals in Lagos, Nigeria

2021 ◽  
Vol 10 (1) ◽  
pp. e000938
Author(s):  
Olawunmi Olagundoye ◽  
Kees van Boven ◽  
Olufunmilola Daramola ◽  
Kendra Njoku ◽  
Adenike Omosun
Keyword(s):  
Monitoring And Evaluation ◽  
International Classification Of Diseases ◽  
Mortality Data ◽  
General Hospitals ◽  
Average Percentage ◽  
Data Coding ◽  
Classification Of Diseases ◽  
Icd 10 ◽  
The Difference ◽  
Level Of Experience

BackgroundReliable information which can only be derived from accurate data is crucial to the success of the health system. Since encoded data on diagnoses and procedures are put to a broad range of uses, the accuracy of coding is imperative. Accuracy of coding with the International Classification of Diseases, 10th revision (ICD-10) is impeded by a manual coding process that is dependent on the medical records officers’ level of experience/knowledge of medical terminologies.Aim statementTo improve the accuracy of ICD-10 coding of morbidity/mortality data at the general hospitals in Lagos State from 78.7% to ≥95% between March 2018 and September 2018.MethodsA quality improvement (QI) design using the Plan–Do–Study–Act cycle framework. The interventions comprised the introduction of an electronic diagnostic terminology software and training of 52 clinical coders from the 26 general hospitals. An end-of-training coding exercise compared the coding accuracy between the old method and the intervention. The outcome was continuously monitored and evaluated in a phased approach.ResultsResearch conducted in the study setting yielded a baseline coding accuracy of 78.7%. The use of the difficult items (wrongly coded items) from the research for the end-of-training coding exercise accounted for a lower coding accuracy when compared with baseline. The difference in coding accuracy between manual coders (47.8%) and browser-assisted coders (54.9%) from the coding exercise was statistically significant. Overall average percentage coding accuracy at the hospitals over the 12-month monitoring and evaluation period was 91.3%.ConclusionThis QI initiative introduced a stop-gap for improving data coding accuracy in the absence of automated coding and electronic health record. It provides evidence that the electronic diagnostic terminology tool does improve coding accuracy and with continuous use/practice should improve reliability and coding efficiency in resource-constrained settings.

scholarly journals Percutaneous Endoscopic Gastrostomy and Mortality After Stroke in England From 2007 to 2018

Stroke ◽  
2020 ◽  
Vol 51 (12) ◽  
pp. 3658-3663
Author(s):  
Lou Sutcliffe ◽  
Darren Flynn ◽  
Christopher I. Price
Keyword(s):  
Percutaneous Endoscopic Gastrostomy ◽  
Odds Ratio ◽  
International Classification Of Diseases ◽  
Mortality Data ◽  
Oral Nutrition ◽  
Endoscopic Gastrostomy ◽  
Classification Of Diseases ◽  
Swallowing Difficulties ◽  
Trends Over Time

Background and Purpose: Swallowing difficulties are common poststroke. National clinical guidelines recommend feeding by percutaneous endoscopic gastrostomy (PEG) when oral nutrition cannot be maintained although survival benefit might be short term. It is unknown whether a decade of general care improvements have impacted upon PEG provision and outcomes. This retrospective cohort study examined PEG placement and mortality poststroke in England. Methods: National Health Service Hospital Episode Statistics and Office for National Statistics mortality data between April 2007 and March 2018 were linked to identify all admissions in England with stroke-related International Classification of Diseases codes (I61, I63, and I64)±PEG insertion and deaths at 3, 6, and 12 months. Linear and logistic regression examined trends over time and mortality. Results: Patients (923 236) with stroke underwent 17 532 PEG procedures (mean rate 1.9%), with an average reduction of −27 procedures/year ([95% CI, −56 to 1.4]; P =0.06) despite an average increase of 1804 stroke admissions/year. Mortality decreased among cases without a PEG procedure: −190 deaths/year ([95% CI, −276 to −104]; P <0.001) at 3 months, −167 deaths/year ([95% CI, −235 to −98]; P <0.001) at 6 months and −103 deaths/year ([95% CI, −157 to −50]; P <0.01) at 12 months; and also reduced following PEG insertion: −28 deaths/year ([95% CI, −35 to −20]; P <0.001) at 3 months, −33 deaths/year ([95% CI, −46 to −20]; P <0.01) at 6 months and −30 deaths/year ([95% CI, −48 to −13]; P <0.01) at 12 months. With all years combined, PEG insertion was weakly associated with reduced mortality at 3 months (odds ratio, 0.94 [95% CI, 0.90–0.97]) but significantly higher mortality at 6 months (odds ratio, 1.69 [95% CI, 1.64–1.75]) and 12 months (odds ratio, 2.14 [95% CI, 2.08–2.20]). Conclusions: PEG procedures and subsequent deaths have decreased in the context of general mortality reductions after hospitalization for stroke, but survival at 6 and 12 months remains significantly worse for patients with PEG placement.

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