Oh Say I-C-D !

As certifiers and reviewers of death certificates, we pledge allegiance to the mortality stats. The International Classification of Disease, currently in its 11th revision, is the foundation upon which health, disease, and injury trends derived from statistical data can be compared locally, nationally, and internationally (1,2).

Some mortality trends in the U.S.:
• Cardiovascular disease, still the #1 cause of death (3)
• As a result of drug overdoses, unintentional (accidental) deaths now occupy the 3rd leading cause of death bumping chronic respiratory deaths to the 4th spot (3)
• Suicides are now the #2 cause of death, ages 10-19 years (4)
• Out of all injury-associated deaths, those resulting from accidental falls account for the majority of deaths affecting our elders (5)
• The uptrend of women dying during or shortly after pregnancy continues(6)
• Birth defects, still the leading cause of infant deaths (7)
• Fueled by the opioid crisis, the drug overdose death rates continue to soar (8, 9)

How do we come to know of these trends?

The following is from a real death certificate in which a terminal mechanism, common to many types of deaths, was listed as the cause of death:

 

 

Just so happens that there’s a code for that, but which one of the ICD codes below apply?
MC82 Cardiac arrest

MC82.0 Ventricular tachycardia and fibrillation cardiac arrest

MC82.1 Bradycardic cardiac arrest

MC82.2 Asystolic cardiac arrest

MC82.3 Cardiac arrest with pulseless electrical activity

MC82.4 Cardiopulmonary arrest

MC82.Z Cardiac arrest, unspecified

 

Maybe the real cause of death is somewhere under one of these categories:
ICD-11 – Mortality and Morbidity Statistics

01 Certain infectious or parasitic diseases

02 Neoplasms

03 Diseases of the blood or blood-forming organs

04 Diseases of the immune system

05 Endocrine, nutritional or metabolic diseases

06 Mental, behavioural or neurodevelopmental disorders

07 Sleep-wake disorders

08 Diseases of the nervous system

09 Diseases of the visual system

10 Diseases of the ear or mastoid process

11 Diseases of the circulatory system

12 Diseases of the respiratory system

13 Diseases of the digestive system

14 Diseases of the skin

15 Diseases of the musculoskeletal system or connective tissue

16 Diseases of the genitourinary system

17 Conditions related to sexual health

18 Pregnancy, childbirth or the puerperium

19 Certain conditions originating in the perinatal period

20 Developmental anomalies

21 Symptoms, signs or clinical findings, not elsewhere classified

22 Injury, poisoning or certain other consequences of external causes

23 External causes of morbidity or mortality

It’s clear WHO can code it.
The question is how to decode it?
Specificity, the spice of life.

References:
1. World Health Organization: Classifications. Available at: https://www.who.int/classifications/icd/en/
2. World Health Organization: ICD 11 For Morbidty and Mortality Statistics (ICD 11 MMS) 2018 Version. Available at: https://icd.who.int/browse11/l-m/en
3. Centers for Disease Control and Prevention: Leading causes of death. Available at: https://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm
4. National Vital Statistics System Reports: Recent Increases in Injury Mortality Among Children and Adolescents Aged 10–19 Years in the United States: 1999–2016. Available at: https://www.cdc.gov/nchs/data/nvsr/nvsr67/nvsr67_04.pdf
5. Burns E. Deaths from Falls Among Persons Aged ≥65 Years — United States, 2007–2016. Morbidity and Mortality Weekly Report. Available at: https://www.cdc.gov/mmwr/volumes/67/wr/mm6718a1.htm
6. Centers for Disease Control and Prevention. Pregnancy Mortality Surveillance System: Trends In Pregnancy-Related Deaths. Available at: https://www.cdc.gov/reproductivehealth/maternalinfanthealth/pregnancy-mortality-surveillance-system.htm
7. National Vital Statistics System Reprts. Drugs Most Frequently Involved in Drug Overdose Deaths: United States, 2011–2016. Available at: https://www.cdc.gov/nchs/data/nvsr/nvsr67/nvsr67_09-508.pdf
8. Center for Disease Control and Prevention. Infant Mortality. Available at: https://www.cdc.gov/reproductivehealth/maternalinfanthealth/infantmortality.htm
9. Centers for Disease Control and Prevention. Drug Overdose Deaths. Available at: https://www.cdc.gov/drugoverdose/data/statedeaths.html

For more information on how to decode the secret of specificity in death certification, access your declassified copy of:

 

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