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Review
. 2015;45(3):152-60.
doi: 10.1159/000441084. Epub 2015 Oct 28.

Causes of Death Data in the Global Burden of Disease Estimates for Ischemic and Hemorrhagic Stroke

Thomas Truelsen  1 , Lars-Henrik Krarup, Helle K Iversen, George A Mensah, Valery L Feigin, Luciano A Sposato, Mohsen Naghavi
Affiliations
Review

Causes of Death Data in the Global Burden of Disease Estimates for Ischemic and Hemorrhagic Stroke

Thomas Truelsen et al. Neuroepidemiology. 2015.

Abstract

Background: Stroke mortality estimates in the Global Burden of Disease (GBD) study are based on routine mortality statistics and redistribution of ill-defined codes that cannot be a cause of death, the so-called 'garbage codes' (GCs). This study describes the contribution of these codes to stroke mortality estimates.

Methods: All available mortality data were compiled and non-specific cause codes were redistributed based on literature review and statistical methods. Ill-defined codes were redistributed to their specific cause of disease by age, sex, country and year. The reassignment was done based on the International Classification of Diseases and the pathology behind each code by checking multiple causes of death and literature review.

Results: Unspecified stroke and primary and secondary hypertension are leading contributing 'GCs' to stroke mortality estimates for hemorrhagic stroke (HS) and ischemic stroke (IS). There were marked differences in the fraction of death assigned to IS and HS for unspecified stroke and hypertension between GBD regions and between age groups.

Conclusions: A large proportion of stroke fatalities are derived from the redistribution of 'unspecified stroke' and 'hypertension' with marked regional differences. Future advancements in stroke certification, data collections and statistical analyses may improve the estimation of the global stroke burden.

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Figures

FIG. 1
FIG. 1
Fraction of “garbage codes” in whole vital registration data with ICD9 and ICD 10 format at the global level, all ages, men and women combined, and by year
FIG. 2
FIG. 2
Fraction of “garbage codes” in whole vital registration data with ICD 10 format at the global level, by age, men and women combined, for year 2005
FIG. 3
FIG. 3
Fraction of “unspecified stroke” assigned to the three type of stroke at the global level by age and sex.
Fig. 4
Fig. 4
Fraction of “unspecified stroke” assigned to the three type of stroke by GBD region in men aged 50–69 years
FIG. 5
FIG. 5
Fraction of death coded due to hypertension assigned to the different target code by age and sex at the global level
FIG. 6
FIG. 6
Fraction of death coded due to hypertension assigned to the different target codes in females aged 50 – 69 years, regional level
See this image and copyright information in PMC

References

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    1. Krarup LH, Boysen G, Janjua H, Prescott E, Truelsen T. Validity of stroke diagnoses in a national register of patients. Neuroepidemiology. 2007;28:150–154. - PubMed

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