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TECHNICAL NOTE 2 CAUSES OF DEATH REVISIONS 2008 AND 2009


OVERVIEW

1 There have been two process improvements implemented by the ABS in recent years which have improved the quality of data, with the biggest improvements seen in the external cause chapter and for coroner certified deaths. These processes were both implemented for the 2008 reference year. The first was a revisions process outlined in Explanatory Notes 35-39 and the second was in relation to the use of additional information from the medical certificate cause of death and from information stored within reports on the NCIS, see Explanatory Notes 63-73 for further information. The following technical note outlines the impact of these two processes.

2 Previous publications of the Causes of Death, Australia indicated that all coroner certified deaths registered after 1 January 2007 are now subject to a revisions process. In order to improve the quality of historical data, the 2006 reference year data has also been revised as part of the Causes of Death, Australia, 2010 release. Therefore in the current release 2006, 2007 and 2008 data is final, 2009 data is revised and 2010 data is preliminary. 2009 and 2010 data is subject to further revisions.


PRELIMINARY CODING

3 This section provides preliminary data for the 2007-2010 reference years. Figure 1 provides information on the number of deaths allocated codes which have no specifity of cause (R99), mechanism (X59, X84 and Y09) or intent (Y10-Y34). Over the period from 2007 to 2010 there has been:

• a reduction in the number of deaths coded to R99 (other ill-defined and unspecified causes of mortality) from a high of 0.8% (1160) of all deaths in 2007 to 0.5% (779) in 2008 and 0.4% (605 and 504) in 2009 and 2010 respectively;
• a reduction in the number of deaths coded to unspecified mechanism codes (X59-Accident, X84-Intentional self-harm, Y09-Assault) from 0.2% (262) of all deaths in 2008 to 0.1% of all deaths in 2009 (117) and 2010 (93);
• a reduction in the number of deaths with an undetermined intent from 0.8% in 2007 (1088) to 0.5% (680) in 2010.

Selected Causes of Death, Preliminary Data - Australia - 2007-2010(a)

• Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99) - reduction of 390 deaths
• Diseases of the circulatory system (I00-I99) - increase of 217 deaths
• External causes of morbidity and mortality (V01-Y98) - increase of 96 deaths

Table 1 - CAUSES OF DEATH REVISIONS , (PRELIMINARY, REVISED, FINAL) - by ICD-10 chapter - 2008
	2008			Change (prelim to final)
	P	R	F
Cause of death and ICD-10 code	no	no	no	no	%
Certain infectious and parasitic diseases (A00-B99)	1 935	1 966	1 969	34	1.8
Neoplasms (C00-D48)	42 418	42 421	42 423	5	0.0
Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism D50-D89	503	503	504	1	0.2
Endocrine, nutritional and metabolic diseases (E00-E90)	5 900	5 899	5 887	-13	-0.2
Mental and behavioural disorders (F00-F99)	6 406	6 408	6 377	-29	-0.5
Diseases of the nervous system (G00-G99)	5 961	5 971	5 983	22	0.4
Diseases of the circulatory system (I00-I99)	48 456	48 455	48 673	217	0.4
Diseases of the respiratory system (J00-J99)	11 260	11 270	11 275	15	0.1
Diseases of the digestive system (K00-K93)	4 939	4 946	4 970	31	0.6
Diseases of the skin and subcutaneous tissue (L00-L99)	401	401	399	-2	-0.5
Diseases of the musculoskeletal system and connective tissue (MOO-M99)	1 179	1 178	1 171	-8	-0.7
Diseases of the genitourinary system (N00-N99)	3 319	3 326	3 333	14	0.4
Certain conditions originating in the perinatal period (P00-P96)	595	597	596	1	0.2
Congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)	609	606	614	5	0.8
Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99)	1 243	1 157	853	-390	-31.4
External causes of morbidity and mortality (V01-Y98)	8 804	8 824	8 900	96	1.1
Total(a)	143 946	143 946	143 946	0	0.0
(a) Includes deaths coded to H00-H59, H60-H95, and O00-O99.

Table 2 - CAUSES OF DEATH REVISIONS, by selected ICD-10 chapter - changes from preliminary to final data: by percentage - 2007 and 2008
	2007	2008
Cause of death and ICD-10 code	%	%
Certain infectious and parasitic diseases (A00-B99)	-0.1	1.8
Neoplasms (C00-D48)	0.1	0.0
Diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism D50-D89	0.8	0.2
Endocrine, nutritional and metabolic diseases (E00-E90)	0.5	-0.2
Mental and behavioural disorders (F00-F99)	-0.4	-0.5
Diseases of the nervous system (G00-G99)	0.3	0.4
Diseases of the circulatory system (I00-I99)	0.7	0.4
Diseases of the respiratory system (J00-J99)	0.4	0.1
Diseases of the digestive system (K00-K93)	0.9	0.6
Diseases of the skin and subcutaneous tissue (L00-L99)	0.6	-0.5
Diseases of the musculoskeletal system and connective tissue (MOO-M99)	1.3	-0.7
Diseases of the genitourinary system (N00-N99)	0.2	0.4
Certain conditions originating in the perinatal period (P00-P96)	1.6	0.2
Congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)	3.7	0.8
Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99)	-46.4	-31.4
External causes of morbidity and mortality (V01-Y98)	4.3	1.1

• Other ill-defined and unspecified causes of mortality (406 deaths)
• Event of undetermined intent (671 deaths)
• Accidental exposure to other and unspecified factors (108 deaths).

• Accidental poisoning by and exposure to noxious substances (254 deaths)
• Intentional self-harm (150 deaths)
• Falls (113 deaths)
• Car occupant injured in transport accident (87 deaths)
• Assault (48 deaths)

TABLE 3: CAUSES OF DEATH REVISIONS (PRELIMINARY, REVISED, FINAL), by ICD-10 selected causes - 2008
	2008			Change (preliminary to final)
	Preliminary	Revised	Final
Cause of death and ICD-10 code	no.	no.	no.	no	%
Sudden infant death syndrome (R95)	59	67	77	18	30.5
Other ill-defined and unspecified causes of mortality (R99)	874	778	468	-406	-46.5
Pedestrian injured in transport accident (V01-V09)	183	206	228	45	24.6
Pedal cyclist injured in transport accident (V10-V19)	24	26	28	4	16.7
Motorcycle rider injured in transport accident (V20-V29)	226	251	270	44	19.5
Car occupant injured in transport accident (V40-V49)	742	795	829	87	11.7
Occupant of pick-up truck or van injured in transport accident (V50-V59)	34	51	69	35	102.9
Occupant of heavy transport vehicle injured in transport accident (V60-V69)	41	47	52	11	26.8
Other land transport accidents (V80-V89)	54	62	56	2	3.7
Water transport accidents (V90-V94)	32	33	37	5	15.6
Air and space transport accidents (V95-V97)	44	42	48	4	9.1
Falls (W00-W19)	1 348	1 412	1 461	113	8.4
Exposure to inanimate mechanical forces (W20-W49)	85	95	100	15	17.6
Accidental drowning and submersion (W65-W74)	159	169	184	25	15.7
Other accidental threats to breathing (W75-W84)	208	219	224	16	7.7
Exposure to smoke, fire and flames (X00-X09)	72	78	84	12	16.7
Exposure to forces of nature (X30-X39)	58	58	60	2	3.4
Accidental poisoning by and exposure to noxious substances (X40-X49)	622	784	876	254	40.8
Accidental exposure to other and unspecified factors (X58-X59)	878	815	770	-108	-12.3
Intentional self-harm (X60-X84)(a)	2 190	2 281	2 340	150	6.8
Assault (X85-Y09)	203	215	251	48	23.6
Event of undetermined intent (Y10-Y34)	1 162	749	491	-671	-57.7
Drugs, medicaments and biological substances causing adverse effects in therapeutic use (Y40-Y59)	48	49	51	3	6.3
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	181	-6	-3.2
Sequelae of external causes of morbidity and mortality (Y85-Y89)	156	153	153	-3	-1.9
(a) Care needs to be taken in interpreting figures relating to suicide. See Explanatory Notes 98-101.

• Deaths due to intentional self-harm increased by 18.5% (347 deaths) between preliminary and final coding for the 2007 reference year, but only increased by 6.8% (150 deaths) in the 2008 reference year.
• Deaths due to event of undetermined intent decreased by 66.7% (726 deaths) and 57.7% (671 deaths) for the 2007 and 2008 reference years.