Certification of death from ischaemic heart disease in Belfast
Insights
This study found that death certificate data for ischaemic heart disease (IHD) in Belfast was generally accurate. However, only 19% of IHD deaths were confirmed as definite myocardial infarction.
Area of Science:
- Cardiology
- Public Health
- Mortality Statistics
Background:
- Ischaemic heart disease (IHD) is a significant cause of mortality.
- Accurate classification of IHD deaths is crucial for public health surveillance and resource allocation.
- International Classification of Diseases (ICD) codes are used to categorize causes of death.
Purpose of the Study:
- To assess the accuracy of ischaemic heart disease (IHD) death registrations in Belfast.
- To determine the proportion of IHD deaths accurately classified using ICD codes (specifically ICD Nos 410-414).
- To evaluate the reliability of coding for acute myocardial infarction (AMI) within IHD deaths.
Main Methods:
- Retrospective analysis of all death certificates for Belfast residents over a one-year period (July 1981-July 1982).
- Cross-referencing death certificate data with hospital records, ECGs, cardiac enzyme results, post-mortems, and general practitioner information.
- Exclusion and inclusion of deaths based on ICD coding (9th revision) and World Health Organization (WHO) criteria for myocardial infarction.
Main Results:
- 1654 death certificates were initially examined for potential ischaemic heart disease (IHD).
- After exclusions and adjustments, the total number of IHD deaths was found to be reasonably accurate for Belfast.
- For deaths coded under ICD Nos 410-414, only 19% met the WHO criteria for definite myocardial infarction, with 76% coded specifically as acute myocardial infarction (ICD No 410).
Conclusions:
- The overall recording of deaths due to ischaemic heart disease (IHD) in Belfast is considered reasonably accurate.
- There is a notable discrepancy between deaths registered as IHD and those definitively classified as myocardial infarction.
- Further refinement in diagnostic criteria and coding practices for myocardial infarction may be warranted.
Abstract:
All death certificates over a one-year period (20 July 1981 to 19 July 1982) for residents of Belfast were examined in order to ascertain those due to ischaemic heart disease. Some 1654 were included for further investigation of which 1288 (78%) were coded by ICD Nos 410-414 (9th revision). Additional data were obtained from hospital records, ECGs, cardiac enzyme measurements, post mortems, general practitioners and from relatives of the deceased. Some 108 deaths coded by 410-414 and 223 deaths coded by other rubrics were eventually excluded. For people aged less than 70 years the net effect of excluding these deaths and including some coded under rubrics other than 410-414 was very small representing a change from 498 to 496 deaths (-0.4%). For people aged 70 years and above the net effect also was small, namely an increase from 790 to 827 (+4.4%). We conclude that the total number of deaths recorded as being due to IHD in Belfast was reasonably accurate. While 76% of deaths registered under ICD Nos 410-414 had been coded by ICD No 410 (acute myocardial infarction) only 19% of all deaths due to IHD could be classified as definite myocardial infarction using World Health Organization criteria.
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