Obscuring effect of coding developmental disability as the underlying cause of death on mortality trends for adults with developmental disability: a cross-sectional study using US Mortality Data from 2012 to 2016
Obscuring effect of coding developmental disability as the underlying cause of death on mortality trends for adults with developmental disability: a cross-sectional study using US Mortality Data from 2012 to 2016
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DOI：
10.1136/bmjopen-2018-026614
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发表时间：
2019-06-01
期刊：
影响因子：
2.9
通讯作者：
Turk, Margaret A.
中科院分区：
文献类型：
--
作者：
Landes, Scott D.;Stevens, James Dalton;Turk, Margaret A.
目的探讨将发育障碍编码为潜在死亡原因是否会掩盖成人发育障碍患者的死亡率趋势。设计国家生命统计系统2012-2016年美国多死因死亡率档案。美国设置。参与者在死亡证明上注明患有发育性残疾，死亡时年龄在18至103岁之间。研究人群包括在2012年1月1日至2016年12月31日期间死亡的33 154名成年人。主要结果和措施使用《疾病和相关健康问题国际统计分类》第十次修订的智力残疾、脑瘫、唐氏综合症或其他发育残疾代码，确定死亡证明上编码为潜在死亡原因的发育残疾的死者。将发育性残疾编码为潜在死亡原因的死亡证明使用顺序的潜在死亡原因修订过程进行了修订。结果33 154例发育障碍患者中，智力障碍7901例，脑瘫11895例，唐氏综合征9114例，其他发育障碍2479例，多重发育障碍1765例。在所有死者中，48.5%的发育障碍被编码为潜在的死亡原因，这掩盖了所有死者中较高的窒息死亡率，以及唐氏综合症患者中痴呆和阿尔茨海默病的死亡率。结论在死亡证明第一部分中记录发育性残疾的死亡证明更有可能将残疾编码为潜在的死亡原因。虽然修改这些死亡证明可以在短期内纠正这一人口的死亡率趋势，但这一问题的严重性和程度需要进行长期改变，包括更精确地指示只在死亡证明的第二部分中记录发育障碍。
Objective To determine whether coding a developmental disability as the underlying cause of death obscures mortality trends of adults with developmental disability.Design National Vital Statistics System 2012-2016 US Multiple Cause-of-Death Mortality files.Setting USA.Participants Adults with a developmental disability indicated on their death certificate aged 18 through 103 at the time of death. The study population included 33 154 adults who died between 1 January 2012 and 31 December 2016.Primary outcome and measures Decedents with a developmental disability coded as the underlying cause of death on the death certificate were identified using the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision code for intellectual disability, cerebral palsy, Down syndrome or other developmental disability. Death certificates that coded a developmental disability as the underlying cause of death were revised using a sequential underlying cause of death revision process.Results There were 33 154 decedents with developmental disability: 7901 with intellectual disability, 11 895 with cerebral palsy, 9114 with Down syndrome, 2479 with other developmental disabilities and 1765 with multiple developmental disabilities. Among all decedents, 48.5% had a developmental disability coded as the underlying cause of death, obscuring higher rates of choking deaths among all decedents and dementia and Alzheimer's disease among decedents with Down syndrome.Conclusion Death certificates that recorded the developmental disability in Part I of the death certificate were more likely to code disability as the underlying cause of death. While revising these death certificates provides a short-term corrective to mortality trends for this population, the severity and extent of this problem warrants a long-term change involving more precise instructions to record developmental disabilities only in Part II of the death certificate.