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. 2024 Jun 5;24(1):129.
doi: 10.1186/s12874-024-02238-x.

Cause of death coding in asthma

Alexandria Chung  1 , George Addo Opoku-Pare  1 , Holly Tibble  2   3
Affiliations

Cause of death coding in asthma

Alexandria Chung et al. BMC Med Res Methodol. .

Erratum in

  • Correction: Cause of death coding in asthma.
    Chung A, Opoku-Pare GA, Tibble H. Chung A, et al. BMC Med Res Methodol. 2025 Apr 22;25(1):105. doi: 10.1186/s12874-025-02550-0. BMC Med Res Methodol. 2025. PMID: 40264001 Free PMC article. No abstract available.

Abstract

Background: While clinical coding is intended to be an objective and standardized practice, it is important to recognize that it is not entirely the case. The clinical and bureaucratic practices from event of death to a case being entered into a research dataset are important context for analysing and interpreting this data. Variation in practices can influence the accuracy of the final coded record in two different stages: the reporting of the death certificate, and the International Classification of Diseases (Version 10; ICD-10) coding of that certificate.

Methods: This study investigated 91,022 deaths recorded in the Scottish Asthma Learning Healthcare System dataset between 2000 and 2017. Asthma-related deaths were identified by the presence of any of ICD-10 codes J45 or J46, in any position. These codes were categorized either as relating to asthma attacks specifically (status asthmatic; J46) or generally to asthma diagnosis (J45).

Results: We found that one in every 200 deaths in this were coded as being asthma related. Less than 1% of asthma-related mortality records used both J45 and J46 ICD-10 codes as causes. Infection (predominantly pneumonia) was more commonly reported as a contributing cause of death when J45 was the primary coded cause, compared to J46, which specifically denotes asthma attacks.

Conclusion: Further inspection of patient history can be essential to validate deaths recorded as caused by asthma, and to identify potentially mis-recorded non-asthma deaths, particularly in those with complex comorbidities.

Keywords: Asthma; ICD-10; Mortality.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
The chain of events from death to record being entered in the national mortality database
Fig. 2
Fig. 2
Number of cause of death codes provided per death, per year
See this image and copyright information in PMC

References

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