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Abstract
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OBJECTIVE--This study evaluated the quality of the cause- of-death information on death certificates for injury deaths, by determining the percentage of deaths for which the underlying cause was a nonspecific injury mechanism.
Methods--Injury deaths were identified from 2019 National Vital Statistics System mortality data using underlying-cause-of- death (UCOD) codes U01-U03, V01-Y36, Y85-Y87, and Y89. Deaths were categorized by intent and mechanism of injury
using the ICD-10 External Cause of Injury Mortality Matrix. The percentage of injury deaths assigned a nonspecific injury mechanism UCOD code was determined for various intent and mechanism categories.
Results--In 2019, 246,041 injury deaths occurred, of which 173,040 were unintentional, 47,511 suicide and intentional self-harm, 19,141 homicide, 5,683 undetermined intent, and 666 resulting from legal intervention and war operations. The percentage of deaths assigned a nonspecific UCOD mechanism code varied from 0.2% for suicide and intentional self-harm deaths to 10.6% for injury deaths of undetermined intent. Within an intent-by-mechanism-of-injury category, more specific injury mechanism codes can be assigned if sufficient information is provided on the death certificate. Otherwise, a nonspecific injury mechanism is assigned. What is considered to be specific varies for each injury mechanism. For most unintentional injury mechanism categories, less than 15% of the deaths received a nonspecific mechanism code. Percentages were higher for unintentional falls (44.6%), motor vehicle traffic (31.1%), and firearm-related (75.9%) deaths. High percentages were also seen for firearm-related suicides (62.9%) and firearm-related homicides (89.5%). The percentage of deaths with a nonspecific injury mechanism UCOD code varied by state.
Conclusions--Death certificate documentation allowed assignment of a general mechanism of injury for the majority of injury deaths in 2019. Improvements in documentation are most needed for deaths involving falls, motor vehicles, and firearms. Study results can help inform medical examiners, coroners, and other death certifiers about the need to improve cause-of-death statements to enhance the usefulness of mortality data for public health.
Keywords: death certification • International Classification of Diseases, 10th Revision • National Vital Statistics System,
Mortality
Language: en |