Availability of ICD-10 cause of death codes in the National Coroners Information System (NCIS) strengthens its value as a public health surveillance tool. This study quantified the completeness of external cause ICD-10 codes in the NCIS for Victorian deaths (as assigned by the Australian Bureau of Statistics (ABS) in the yearly Cause of Death data). It also examined the concordance between external cause ICD-10 codes contained in the NCIS and a re-code of the same deaths conducted by an independent coder. Of 7,400 NCIS external cause deaths included in this study, 961 (13.0%) did not contain an ABS assigned ICD-10 code and 225 (3.0%) contained only a natural cause code. Where an ABS assigned external cause ICD-10 code was present (n=6,214), 4,397 (70.8%) matched exactly with the independently assigned ICD-10 code. Coding disparity primarily related to differences in assignment of intent and specificity. However, in a small number of deaths (n=49, 0.8%) there was coding disparity for both intent and external cause category. NCIS users should be aware of the limitations of relying only on ICD-10 codes contained within the NCIS for deaths prior to 2007 and consider using these in combination with the other NCIS data fields and code sets to ensure optimum case identification.
Although harmful consumption of alcohol and other drugs (both illicit and pharmaceutical) significantly contribute to global burden of disease, not all harms are captured within existing morbidity data sources. Indeed, harms occurring in the community may be missed or underreported. This paper describes the National Ambulance Surveillance System, a unique Australian system for monitoring and mapping acute harms related to alcohol and other drug consumption. Data are sourced from paramedic electronic patient care records provided by ambulance services from across Australia. Coding occurs in a purpose-built system, by a team of specialised research assistants. Alcohol, and specific illicit and pharmaceutical drugs, rather than broad drug classes, are manually coded and the dataset is reviewed and cleaned prior to analysis. The National Ambulance Surveillance System is an ongoing, dynamic surveillance system of alcohol and other drug-related harms across Australia. The data includes more than 140 output variables per attendance, including individual substances, demographics, temporal, geospatial, and clinical data (e.g., Glasgow Coma Scale score, naloxone provision and response, outcome of attendance). The National Ambulance Surveillance System is an internationally unique population-level surveillance system of acute harms arising from alcohol and other drug consumption. Dissemination of National Ambulance Surveillance System data has been used to inform and evaluate policy approaches and potential points of intervention, as well as guide workforce development
Proteomics provides a valuable approach to examine storage-related effects on RBCs. Such analytical approaches may help to elucidate the mechanisms involved in the RBC storage lesion and provide insights into the biologic consequences of transfusion of stored RBC products.
Background and aims Although the prevalence of gamma‐hydroxybutyrate (GHB) use is relatively low globally, harms related to the drug appear to be increasing. Few existing studies present reliable, representative, population‐level data on GHB‐related harms. The aim of this study was to investigate trends in acute GHB‐related harms within an ambulance database in Australia. Design, setting and participants Cross‐sectional, retrospective analysis of data on all GHB‐related ambulance attendances in the state of Victoria, Australia during a 7‐year period (January 2012–December 2018) Measurements Presentations were characterized based on patient demographics, transport to hospital, co‐occurring substance use (i.e. GHB only, alcohol, methamphetamine, heroin, benzodiazepine and cannabis) and clinical presentation (e.g. symptoms of anxiety, psychosis, depression). Findings There were 5866 GHB‐related ambulance attendances between 2012 and 2018, with the prevalence rate increasing from 8.8 per 100 000 population in 2012 to a maximum of 21.7 per 100 000 population in 2017. Methamphetamine [odds ratio (OR) = 6.23, P < 0.001] and benzodiazepine‐related (OR = 1.43, P < 0.001) co‐occurrences; ages between 18–29 (OR = 6.58, P < 0.001) and 30–39 years (OR = 2.02, P < 0.001); and male gender (OR = 1.23, P < 0.001) were significant predictors of GHB‐related attendances. Conclusions There has been a 147% increase in the prevalence of GHB‐related ambulance attendances in Victoria, Australia between 2012 and 2019, largely attributable to a growth in the proportions of people using gamma‐hydroxybutyrate alone or concurrently with methamphetamine.
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