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
