External Cause of Injury Mortality Matrix Lois A. Fingerhut on behalf on the ICE on Injury...

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External Cause of Injury Mortality Matrix

Lois A. Fingerhut on behalf on the

ICE on Injury Statistics

October 2004

Centers for Disease Control and PreventionNational Center for Health Statistics

Current WHO Tabulation Lists

• Not ideal for the analysis of injury data

• Mechanisms missing for intentional deaths– Suicides

• Firearm, poisoning, suffocation

– Homicides• Firearm, cut/pierce

• Undetermined intent not included

External Cause Categories from the WHO Special Tabulation Lists

External causes of morbidity and mortality

Transport accidents

Falls

Accidental drowning and submersion

Other accidental threats to breathing

Exposure to smoke, fire and flames

Accidental poisoning by and exposure to noxious substances

Intentional self-harm

Assault

All other external causes

External Cause Categories from the WHO Special Tabulation Lists

External causes of morbidity and mortality

Transport accidents

Falls

Accidental drowning and submersion

Other accidental threats to breathing

Exposure to smoke, fire and flames

Accidental poisoning by and exposure to noxious substances

Intentional self-harm

Assault

All other external causes

External Causes in the WHO Mortality Database Tabulation List

Accidents and adverse effects

Motor vehicle traffic accidents

Other transport accidents

Accidental poisoning

Accidental falls

Accidents caused by fire and flames

Accidental drowning and submersion

Accidents caused by firearm missile

All other accidents, including late effects

Drugs, medicaments causing adverse effects in therapeutic use

Suicide and self-inflicted injury

Homicide and injury purposely inflicted by other persons

Other external causes

External Causes in the WHO Mortality Database Tabulation List

Accidents and adverse effects

Motor vehicle traffic accidents

Other transport accidents

Accidental poisoning

Accidental falls

Accidents caused by fire and flames

Accidental drowning and submersion

Accidents caused by firearm missile

All other accidents, including late effects

Drugs, medicaments causing adverse effects in therapeutic use

Suicide and self-inflicted injury

Homicide and injury purposely inflicted by other persons

Other external causes

What if we need to look at specific mechanisms of injury?• Firearms?

– No categories in the special tabulation lists

– Only accidental firearm deaths in the Mortality Database list

• Poisonings?– Only accidental poisonings shown in

both lists

Proposed Modifications and Additions to Current Lists

• Current lists modified to include all intent categories– Add undetermined intent– Add legal intervention/operations of

war– Ensure unintentional categories sum

to total unintentional deaths

External Causes in the WHO Mortality Database Tabulation List

Accidents and adverse effects

Motor vehicle traffic accidents

Other transport accidents

Accidental poisoning

Accidental falls

Accidents caused by fire and flames

Accidental drowning and submersion

Accidents caused by firearm missile

All other accidents, including late effects

Drugs, medicaments causing adverse effects in therapeutic use

Suicide and self-inflicted injury

Homicide and injury purposely inflicted by other personsEvents of undetermined intent

Other external causes or Legal intervention/operations of war

Proposed Modifications and Additions to Current Lists

(cont.)• Add External Cause of Injury

Mortality Matrix as additional list– Developed by the ICE on Injury

Statistics– Internationally accepted

External Cause of Injury Mortality Matrix

External Cause of Injury Mortality Matrix

Intent of death

External Cause of Injury Mortality Matrix

Mechanism of death

Two Proposed Levels of Detail

• Level 1– Based on mechanism or cause only

• Level 2– Includes each combination of

mechanism and intent

Injury deaths by mechanism: US, 2002 (Level 1)

0

5,000

10,000

15,000

20,000

25,000

30,000

35,000

40,000

45,000

50,000

MotorVehicleTraffic

Firearm Poisoning Falls Suffocation Drowning

Selected Mechanisms of injury

Nu

mb

er o

f dea

ths

Injury Deaths according to matrix: US, 2002 (Level 2)

0

5,000

10,000

15,000

20,000

25,000

30,000

35,000

40,000

45,000

50,000

MotorVehicleTraffic

Firearm Poisoning Falls Suffocation Drowning

Selected Mechanisms of injury

Nu

mb

er

of

de

ath

s

Unintentional Self-harm Assault Undetermined Legal int/other

Relationship between ICECI and ICD-10 Chapter XX

ICECI

Intent, Mechanism,

Transport module

Bridge

IntentM

ech

an

ism

External cause matrix categories

ICD

Chapter XX – External causes

Questions?

Lois FingerhutUS National Center for Health

StatisticsLFingerhut@cdc.gov