TECHNICAL NOTE CAUSES OF DEATH REVISIONS


TECHNICAL NOTE CAUSES OF DEATH REVSIONS

OVERVIEW

1 All coroner certified deaths registered after 1 January 2007 are now subject to a revisions process. For information on the revisions process see Explanatory Notes 28-32 for further information.

2 This technical note outlines the impact of the revisions process on 2007 data (where two years of revisions have been conducted) and 2008 data (where revisions have been conducted for one year).


2007 REGISTRATION YEAR

3 Table 1 shows the impact of the revisions on the 2007 data at the ICD-10 chapter level as the data has moved from being preliminary through to revised and then final. ICD-10 chapters most notably impacted through the full revisions process were:

• Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99) - reduction of 879 deaths
• External causes of morbidity and mortality (V01-Y98) - increase of 337 deaths
• Diseases of the circulatory system (I00-I99) - increase of 332 deaths.

TABLE 1: Causes of Death Revisions (Preliminary, Revised, Final) - by ICD-10 chapter: 2007
	Preliminary	Revised	Final	Change (preliminary to final)	Change (Preliminary to Final)
	no	no	no	no	%
Certain infectious and parasitic diseases (A00-B99)	1 858	1 860	1 857	-1	-0.1
Neoplasms (C00-D48)	40 287	40 305	40 331	44	0.1
Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (D50-D89)	479	480	483	4	0.8
Endocrine, nutritional and metabolic diseases (E00-E90)	5 355	5 367	5 380	25	0.5
Mental and behavioural disorders (F00-F99)	5 715	5 716	5 693	-22	-0.4
Diseases of the nervous system (G00-G99)	5 467	5 474	5 485	18	0.3
Diseases of the circulatory system (I00-I99)	46 626	46 821	46 958	332	0.7
Diseases of the respiratory system (J00-J99)	11 577	11 596	11 623	46	0.4
Diseases of the digestive system (K00-K93)	4 760	4 789	4 804	44	0.9
Diseases of the skin and subcutaneous tissue (L00-L99)	362	363	364	2	0.6
Diseases of the musculoskeletal system and connective tissue (M00-M99)	1 091	1 091	1 105	14	1.3
Diseases of the genitourinary system (N00-N99)	3 324	3 327	3 331	7	0.2
Certain conditions originating in the perinatal period (P00-P96)	578	585	587	9	1.6
Congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)	574	582	595	21	3.7
Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99)	1 895	1 419	1 016	-879	-46.4
External causes of morbidity and mortality (V01-Y98)	7 893	8 066	8 230	337	4.3
Total(a)	137 854	137 854	137 854	-	-
- nil or rounded to zero (including null cells)
(a) Includes deaths due to Diseases of the eye and adnexa (H00-H59), Diseases of the ear and mastoid process (H60-H95) and Pregnancy, childbirth and puerperium (O00-O99)

4 The reduction in the number of deaths assigned to Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99) is a positive outcome from the revisions process. This reflects how additional information that has become available after the preliminary data has been released has assisted coders in assigning a more specific underlying cause of death. The increase in deaths assigned to External causes of morbidity and mortality (V01-Y98) and Diseases of the circulatory system (I00-I99) are also expected as these make up the majority (75.6%) of all coroner certified deaths.

5 Table 2 provides more detail in relation to changes in data associated with the revisions process concerning selected causes from the External causes of morbidity and mortality (V01-Y98) and Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99) chapters.

6 The number of deaths in 2007 due to the following selected causes notably reduced as a result of the revisions process:

• Other ill-defined and unspecified causes of mortality (877 deaths)
• Event of undetermined intent (726 deaths)
• Accidental exposure to other and unspecified factors (114 deaths).

7 The number of deaths in 2007 due to the following selected causes notably increased as a result of the revisions process:

• Intentional self-harm (347 deaths)
• Accidental poisoning by and exposure to noxious substances (188 deaths)
• Car occupant injured in transport accident (148 deaths)
• Falls (147 deaths)
• Other land transport accidents (60 deaths)
• Assault (54 deaths).

Table 2: Selected Causes of Death Revisions (Preliminary, Revised, Final): 2007
	Preliminary	Revised	Final	Change (preliminary to final)	Change (Preliminary to Final)
	no	no	no	no	%
Sudden infant death syndrome (R95)	71	83	82	11	15.5
Other ill-defined and unspecified causes of mortality (R99)	1 287	802	410	-877	-68.1
Pedestrian injured in transport accident (V01-V09)	182	210	231	49	26.9
Pedal cyclist injured in transport accident (V10-V19)	34	34	45	11	32.4
Motorcycle rider injured in transport accident (V20-V29)	184	201	230	46	25.0
Car occupant injured in transport accident (V40-V49)	710	756	858	148	20.8
Occupant of pick-up truck or van injured in transport accident (V50-V59)	53	61	74	21	39.6
Occupant of heavy transport vehicle injured in transport accident (V60-V69)	32	37	50	18	56.3
Other land transport accidents (V80-V89)	71	76	131	60	84.5
Water transport accidents (V90-V94)	31	32	36	5	16.1
Air and space transport accidents (V95-V97)	36	42	53	17	47.2
Falls (W00-W19)	1 190	1 223	1 337	147	12.4
Exposure to inanimate mechanical forces (W20-W49)	82	89	107	25	30.5
Accidental drowning and submersion (W65-W74)	183	186	191	8	4.4
Other accidental threats to breathing (W75-W84)	220	222	229	9	4.1
Exposure to electric current, radiation and extreme ambient air temperature and pressure (W85-W99)	15	19	20	5	33.3
Exposure to smoke, fire and flames (X00-X09)	58	64	72	14	24.1
Exposure to forces of nature (X30-X39)	52	54	55	3	5.8
Accidental poisoning by and exposure to noxious substances (X40-X49)	575	645	763	188	32.7
Accidental exposure to other and unspecified factors (X58-X59)	628	617	514	-114	-18.2
Intentional self-harm (X60-X84)(a)	1 880	2 053	2 227	347	18.5
Assault (X85-Y09)	162	192	216	54	33.3
Event of undetermined intent (Y10-Y34)	1 089	829	363	-726	-66.7
Drugs, medicaments and biological substances causing adverse effects in therapeutic use (Y40-Y59)	59	59	60	1	1.7
Surgical and other medical procedures as the cause of abnormal reaction of the patient, or of later complication, without mention of misadventure at the time of the procedure (Y83-Y84)	187	184	183	-4	-2.1
Sequelae of external causes of morbidity and mortality (Y85-Y89)	140	139	143	3	2.1
(a) Care needs to be taken in interpreting figures relating to suicide. See Explanatory Notes 80-83.

8 The revisions process has increased the specificity of coding in relation to mechanism and intent. This is demonstrated by reductions in the number of deaths categorised using "other" type codes and increases in deaths with more specific mechanism codes. There has also been a reduction in the number of deaths with undetermined intent and a commensurate increase in the number of deaths coded as accidental, intentional self-harm and assault.


2008 REGISTRATION YEAR

9 Compared to 2007, the revisions process has had a smaller impact on the 2008 data. This is considered to be primarily due to improved specificity of 2008 preliminary coding compared with 2007 preliminary coding, see Explanatory Notes 28-32 for further information. It is expected that final revisions on the 2008 data will have further impact as coroners investigate and close more cases.

10 Table 3 shows the impact of the revisions on the 2008 data at the ICD-10 chapter level as the data has moved from being preliminary to revised. The largest change is a decrease of 86 deaths attributed to Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99).

TABLE 3: Causes of Death Revisions (Preliminary, Revised) - by ICD-10 chapter: 2008
	Preliminary	Revised	Change (Preliminary to Revised)	Change (Preliminary to Revised)
	no	no	no	%
Certain infectious and parasitic diseases (A00-B99)	1 935	1 966	31	1.6
Neoplasms (C00-D48)	42 418	42 421	3	-
Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism (D50-D89)	503	503	-	-
Endocrine, nutritional and metabolic diseases (E00-E90)	5 900	5 899	-1	-
Mental and behavioural disorders (F00-F99)	6 406	6 408	2	-
Diseases of the nervous system (G00-G99)	5 961	5 971	10	0.2
Diseases of the circulatory system (I00-I99)	48 456	48 455	-1	-
Diseases of the respiratory system (J00-J99)	11 260	11 270	10	0.1
Diseases of the digestive system (K00-K93)	4 939	4 946	7	0.1
Diseases of the skin and subcutaneous tissue (L00-L99)	401	401	-	-
Diseases of the musculoskeletal system and connective tissue (M00-M99)	1 179	1 178	-1	-0.1
Diseases of the genitourinary system (N00-N99)	3 319	3 326	7	0.2
Certain conditions originating in the perinatal period (P00-P96)	595	597	2	0.3
Congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)	609	606	-3	-0.5
Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99)	1 243	1 157	-86	-6.9
External causes of morbidity and mortality (V01-Y98)	8 804	8 824	20	0.2
Total(a)	143 946	143 946	-	-
- nil or rounded to zero (including null cells)
(a) Includes deaths due to Diseases of the eye and adnexa (H00-H59), Diseases of the ear and mastoid process (H60-H95) and Pregnancy, childbirth and puerperium (O00-O99)

11 Table 4 below shows for 2008, selected causes from the External causes of morbidity and mortality (V01-Y98) and Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99), the two chapters expected to be influenced through the revisions process. Despite an increase of only 20 records overall within the external causes chapter, there have been some larger movements at the 2-character classification level.

12 The number of deaths in 2008 due to the following selected causes notably decreased as part of the revisions process:

• Event of undetermined intent (413 deaths)
• Other ill-defined and unspecified causes of mortality (96 deaths)
• Accidental exposure to other and unspecified factors (63 deaths).

13 The number of deaths in 2008 due to the following selected causes notably increased as part of the revisions process:

• Accidental poisoning by and exposure to noxious substances (162 deaths)
• Intentional self-harm (91 deaths)
• Falls (64 deaths)
• Car occupant injured in transport accident (53 deaths).

Table 4: Selected Causes of Death Revisions (Preliminary, Revised): 2008
	Preliminary	Revised	Change (Preliminary to Revised)	Change (Preliminary to Revised)
	no	no	no	%
Sudden infant death syndrome (R95)	59	67	8	13.6
Other ill-defined and unspecified causes of mortality (R99)	874	778	-96	-11.0
Pedestrian injured in transport accident (V01-V09)	183	206	23	12.6
Motorcycle rider injured in transport accident (V20-V29)	226	251	25	11.1
Car occupant injured in transport accident (V40-V49)	742	795	53	7.1
Occupant of pick-up truck or van injured in transport accident (V50-V59)	34	51	17	50.0
Occupant of heavy transport vehicle injured in transport accident (V60-V69)	41	47	6	14.6
Other land transport accidents (V80-V89)	54	62	8	14.8
Water transport accidents (V90-V94)	32	33	1	3.1
Air and space transport accidents (V95-V97)	44	42	-2	-4.5
Falls (W00-W19)	1 348	1 412	64	4.7
Exposure to inanimate mechanical forces (W20-W49)	85	95	10	11.8
Accidental drowning and submersion (W65-W74)	159	169	10	6.3
Other accidental threats to breathing (W75-W84)	208	219	11	5.3
Exposure to smoke, fire and flames (X00-X09)	72	78	6	8.3
Exposure to forces of nature (X30-X39)	58	58	-	-
Accidental poisoning by and exposure to noxious substances (X40-X49)	622	784	162	26.0
Accidental exposure to other and unspecified factors (X58-X59)	878	815	-63	-7.2
Intentional self-harm (X60-X84)(a)	2 190	2 281	91	4.2
Assault (X85-Y09)	203	215	12	5.9
Event of undetermined intent (Y10-Y34)	1 162	749	-413	-35.5
Drugs, medicaments and biological substances causing adverse effects in therapeutic use (Y40-Y59)	48	49	1	2.1
Surgical and other medical procedures as the cause of abnormal reaction of the patient, or of later complication, without mention of misadventure at the time of the procedure (Y83-Y84)	187	181	-6	-3.2
Sequelae of external causes of morbidity and mortality (Y85-Y89)	156	153	-3	-1.9
- nil or rounded to zero (including null cells)
(a) Care needs to be taken in interpreting figures relating to suicide. See Explanatory Notes 80-83.