The impact of the variation in death certification and coding practices on trends in mortality from ischaemic heart disease

Chen, Linping; Walker, Susan; Tong, Shilu

doi:10.1071/ah020189a

Cited by 14 publications

(12 citation statements)

References 27 publications

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“…We used the primary cause of death on the death certificate for analytic purposes. However, inaccuracies in death certification and the resultant assignment of misleading ICD codes, particularly for cardiovascular conditions, may affect cardiovascular mortality rates and resultant analyses (37) …”

Section: Discussionmentioning

confidence: 99%

High Bone Turnover Is an Independent Predictor of Mortality in the Frail Elderly

Sambrook

Chen

March

et al. 2006

Journal of Bone and Mineral Research

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Osteoporotic fractures are associated with accelerated bone turnover and excess mortality. In a prospective study of 1112 frail subjects (79% female; mean age, 86 years), high bone turnover was an independent predictor of all-cause mortality. This association seemed to be mainly manifested in deaths from cardiovascular causes.Introduction: Osteoporotic fractures are associated with accelerated bone turnover and excess mortality. In a prospective cohort study of elderly men and women, we assessed whether the rate of bone turnover measured by markers of bone remodeling is a direct predictor of mortality. Materials and Methods:We measured serum concentrations of the aminoterminal propeptide of type I collagen (PINP), a marker of bone formation, and of the carboxyterminal telopeptide of type I collagen (CTX-I), a marker of bone resorption, along with serum PTH and 25-hydroxyvitamin D [25(OH)D] levels in 1112 subjects (79% female; mean age, 86 years) living in residential care. Co-morbidity was measured using the Implicit Illness Severity Scale. Fracture data were validated by a radiology report. Mortality and causes of death were ascertained from death certificates. Results: Over a median follow-up of 817 days, 559 (50.3%) subjects died. In univariate analyses, time to death from all causes was significantly (p < 0.01) associated with age (HR ‫ס‬ 1.62 per 10 years), male sex (HR ‫ס‬ 1.33), immobility (HR ‫ס‬ 1.94), co-morbidity (HR ‫ס‬ 0.31, mild versus severe), lower weight (HR ‫ס‬ 0.83 per 10-kg increase), impaired cognitive function (HR ‫ס‬ 2.14, severe versus normal), number of medications (HR ‫ס‬ 1.05 each), hip fracture (HR ‫ס‬ 2.26), log serum creatinine (HR ‫ס‬ 1.67), log PTH (HR ‫ס‬ 1.29), CTX-I (HR ‫ס‬ 1.70, highest 25% versus lowest 75%), and PINP (HR ‫ס‬ 1.46, highest 25% versus lowest 75%). In multivariate analysis adjusting for age, sex, immobility, co-morbidity, weight, cognitive function, number of medications, PTH, and hip fracture status, the highest quartile was significantly more likely to die than the rest for both serum CTX-I (HR ‫ס‬ 1.39; 95% CI: 1.14-1.70; p ‫ס‬ 0.002) and PINP (HR ‫ס‬ 1.25; 95% CI: 1.02-1.52; p ‫ס‬ 0.03). For individual causes of death, CTX-I was significantly associated with deaths from cardiac causes (HR ‫ס‬ 1.78: 95% CI: 1.27-2.50; p < 0.001). Conclusions: We conclude that in the frail elderly, high bone turnover is associated with all cause mortality independently of age, sex, health status, serum PTH levels, and hip fracture status. The mechanism of the effect of bone turnover on mortality seems to be mainly manifested in deaths from cardiovascular causes.

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Section: Discussionmentioning

confidence: 99%

High Bone Turnover Is an Independent Predictor of Mortality in the Frail Elderly

Sambrook

Chen

March

et al. 2006

Journal of Bone and Mineral Research

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“…Approximately 52% of deaths in our population were definitely cardiovascular related (cardiac or cerebrovascular). Inaccuracies in death certification and the resultant assignment of misleading International Classification of Diseases codes, particularly for cardiovascular conditions, can have important effects on cardiovascular mortality rates and trends (37). Also, only a single baseline measurement of the clinical chemistry was obtained.…”

Section: Discussionmentioning

confidence: 99%

Serum Parathyroid Hormone Is Associated with Increased Mortality Independent of 25-Hydroxy Vitamin D Status, Bone Mass, and Renal Function in the Frail and Very Old: A Cohort Study

Sambrook

Chen

March

et al. 2004

The Journal of Clinical Endocrinology &Amp; Metabolism

113

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Very frail older people constitute an increasing proportion of the aging population and often have vitamin D deficiency and impaired renal function. Primary hyperparathyroidism has been associated with increased mortality, but it is unclear whether secondary hyperparathyroidism is associated with increased mortality independent of renal function and vitamin D status. This study aimed to examine the effect of vitamin D deficiency and secondary hyperparathyroidism on mortality in frail older people after accounting for renal function and general measures of health. We evaluated 842 subjects (182 men with a mean age of 81.9 yr and 660 women with a mean age of 86.2 yr) living in residential aged care facilities in Sydney, Australia in a prospective, cohort study. Over a mean duration of follow-up of 31 months, 345 subjects died. Baseline serum 25-hydroxy vitamin D, serum PTH, and bone ultrasound attenuation were significantly associated with mortality in univariate and multivariate analyses (for PTH, a hazard ratio of 1.39 for time to death) after correcting for age and gender. In multivariate analyses that corrected for health status, nutritional status, and renal function, PTH remained a significant predictor of mortality but not 25-hydroxy vitamin D or bone ultrasound attenuation. Serum PTH appears to be associated with increased mortality in the frail elderly independent of vitamin D status, renal function, bone mass, and measures of general health. The mechanism of this effect requires further investigation.

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“…Under ICD-10, which was implemented in 1999, cardiac arrest is considered to be an ill-defined condition [22,23]. In the case of a cardiac arrest, if any other specific condition is listed on the death certificate the underlying cause will be coded as that specific condition and not cardiac arrest.…”

Section: Methodsmentioning

confidence: 99%

Social and demographic predictors of no transport prior to premature cardiac death: United States 1999–2000

Barnett

Reader

Ward

et al. 2006

BMC Cardiovasc Disord

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Background: In the United States, over one-third of premature cardiac deaths occur outside of a hospital, without any transport prior to death. Transport prior to death is a strong, valid indicator of help-seeking behavior. We used national vital statistics data to examine social and demographic predictors of risk of no transport prior to cardiac death. We hypothesized that persons of lower social class, immigrants, non-metropolitan residents, racial/ethnic minorities, men, and younger decedents would be more likely to die prior to transport.

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The impact of the variation in death certification and coding practices on trends in mortality from ischaemic heart disease

Cited by 14 publications

References 27 publications

High Bone Turnover Is an Independent Predictor of Mortality in the Frail Elderly

High Bone Turnover Is an Independent Predictor of Mortality in the Frail Elderly

Serum Parathyroid Hormone Is Associated with Increased Mortality Independent of 25-Hydroxy Vitamin D Status, Bone Mass, and Renal Function in the Frail and Very Old: A Cohort Study

Social and demographic predictors of no transport prior to premature cardiac death: United States 1999–2000

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