量化药物过量死亡:一条从头到尾困难的道路
John J Coleman1, John F Peppin2
1US Drug Enforcement Administration (Retired), Fairfax, Virginia; President, DrugWatch International, Inc., Omaha, Nebraska.
Journal of opioid management
|October 25, 2023
概括
国际疾病分类 (ICD) 编码系统可能会不准确地报告药物过量死亡. 这可能会掩盖真正的原因,比如滥用多种物质,导致疾病控制和预防中心 (CDC) 的数据不完整.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 医学编码 医学编码
背景情况:
- 在美国,在1999年至2019年期间,近45万人因处方阿片类药物过量服用而死亡.
- 疾病控制和预防中心 (CDC) 使用国际疾病分类 (ICD) 编码系统编制药物过量死亡数据.
- 目前的方法可能无法准确地捕捉与药物有关的死亡事故的全部情况.
研究的目的:
- 检查CDC编制药物过量死亡统计数据的方法.
- 评估国际疾病分类 (ICD) 适用于准确编码药物相关死亡率的适用性.
- 确定当前数据收集过程中的局限性,这些局限性可能会掩盖致命药物过量服用的原因.
主要方法:
- 审查疾病预防控制中心对药物过量死亡的源数据.
- 对致命药物过量用药病例中标准死亡证明程序的分析.
- 检查国际疾病分类 (ICD) 编码系统对涉及药物死亡的应用.
主要成果:
- 死亡证明通常在死后毒理学结果可用之前发布,导致潜在的不准确性.
- 含糊不清的术语,如"疑似急性药物中毒"可以列为死亡原因.
- ICD编码系统可能无法捕捉多重物质滥用作为死亡原因的复杂性,从而掩盖了个体物质的致命性.
结论:
- 目前的ICD系统可能不适合准确报告与药物有关的死亡率.
- 数据编制过程可能会导致对致命过量服用中涉及的特定物质的关键信息丢失.
- 需要改进数据收集和编码,以更好地理解和解决药物过量危机,特别是多重物质滥用.
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