Trends in gastroenteritis-associated mortality in the United States, 1985–2005: variations by ICD-9 and ICD-10 codes

Abstract

BackgroundTrends in gastroenteritis-associated mortality are changing over time with development of antibiotic resistant strains of certain pathogens, improved diagnostic methods, and changing healthcare. In 1999, ICD-10 coding was introduced for mortality records which can also affect trends. We assess trends in gastroenteritis-associated mortality and changes associated with coding.MethodsTrends in gastroenteritis-associated mortality rates in the United States were examined using the National Center for Health Statistics Multiple Cause-of-Death Mortality databases for 1985–2005. All deaths with the underlying cause or any contributing cause included gastroenteritis were included. Cases were selected based on ICD9 (pre-1999) and ICD10 (1999–2005) codes and all analyses were stratified by ICD usage. Annual trends in age adjusted mortality rates were assessed using linear regression spline analysis. Relative risks and 95% confidence intervals (CIs) were calculated using Poisson regression adjusted for age group, sex, race, and region.ResultsThere were a total of 190,674 deaths related to gastroenteritis in the U.S. from 1985–2005 with an average of 9,080 per year. During this time the percent of deaths related to gastroenteritis more than tripled, increasing from 0.25% to 0.80% of all deaths. Though the time periods varied in length, we demonstrate a significant increase in slope from a 0.0054% annual increase during the period 1985–1998, when ICD-9 coding was used, to a 0.0550% annual increase during 1999–2005, when ICD-10 coding was used. For both time periods, the oldest age group (75+ years) demonstrated the highest risk of death due to gastroenteritis. Additionally, males demonstrated higher risk than females and blacks were at higher risk than whites for death due to gastroenteritis.ConclusionsThis analysis demonstrates the public health burden of gastroenteritis-associated mortality in the United States and changes in trends due to change from ICD-9 to ICD-10 coding. The overall rate of gastroenteritis-associated mortality has more than tripled over the 21-year period from 1985 to 2005 and the primary burden of deaths due to gastroenteritis is in the elderly population.

The REporting of studies Conducted using Observational Routinely-collected health Data (RECORD) Statement

“…Other codes may be avoided because of patient stigmatization or provider penalties [ 64 ]. In addition, changes in versions of code classification systems (e.g., from International Classification of Diseases (ICD)-9 to ICD-10) may alter the validity of ascertainment using coded data [ 65 , 66 ]. Variation in clinical practice across hospitals and populations may result in laboratory investigations being undertaken in specific locations and/or practices, which may impact a diagnostic algorithm.…”

Perfil de morbimortalidade das principais causas de hospitalização entre pessoas idosas no Brasil

“…As doenças do aparelho cardiovascular apresentaramse como o principal grupo de comorbidades que levam às hospitalizações de pessoas idosas, essas podem ter impactos direto na saúde, por sua capacidade de debilidade funcional, ou indireto, através de efeitos adversos do próprio tratamento, levando o indivíduo a maior dependência do sistema de saúde 26,27 . Isso acarreta grande ônus financeiro para o Estado, como ficou evidenciado no ano de 2016, quando ocorreram 1.125.944 internações no SUS por doenças do aparelho circulatório, a um custo de R$ 2.734.129.065,96 para o sistema 28 .…”

Transcatheter aortic valve replacement in patients with systolic heart failure

“…Jagai and colleagues tested whether trends in gastroenteritis-related mortality changed between ICD-9-CM (1985-1998) and ICD-10-CM/PCS (1999)(2000)(2001)(2002)(2003)(2004)(2005). 52 Significant differences in the slope of the trend between the two coding systems were found for all gastroenteritis-related deaths (all-cause and specific causes), indicating a discontinuity in measurement between the two coding system.…”