Royal Life Saving Society - Australia, Broadway, Australia.
College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia.
BMJ Open. 2017 Dec 21;7(12):e019407. doi: 10.1136/bmjopen-2017-019407.
Fatal drowning estimates using a single underlying cause of death (UCoD) may under-represent the number of drowning deaths. This study explores how data vary by International Classification of Diseases (ICD)-10 coding combinations and the use of multiple underlying causes of death using a national register of drowning deaths.
An analysis of ICD-10 external cause codes of unintentional drowning deaths for the period 2007-2011 as extracted from an Australian total population unintentional drowning database developed by Royal Life Saving Society-Australia (the Database). The study analysed results against three reporting methodologies: primary drowning codes (W65-74), drowning-related codes, plus cases where drowning was identified but not the UCoD.
Australia, 2007-2011.
Unintentional fatal drowning cases.
The Database recorded 1428 drowning deaths. 866 (60.6%) had an UCoD of W65-74 (accidental drowning), 249 (17.2%) cases had an UCoD of either T75.1 (0.2%), V90 (5.5%), V92 (3.5%), X38 (2.4%) or Y21 (5.9%) and 53 (3.7%) lacked ICD coding. Children (aged 0-17 years) were closely aligned (73.9%); however, watercraft (29.2%) and non-aquatic transport (13.0%) were not. When the UCoD and all subsequent causes are used, 67.2% of cases include W65-74 codes. 91.6% of all cases had a drowning code (T75.1, V90, V92, W65-74, X38 and Y21) at any level.
Defining drowning with the codes W65-74 and using only the UCoD captures 61% of all drowning deaths in Australia. This is unevenly distributed with adults, watercraft and non-aquatic transport-related drowning deaths under-represented. Using a wider inclusion of ICD codes, which are drowning-related and multiple causes of death minimises this under-representation. A narrow approach to counting drowning deaths will negatively impact the design of policy, advocacy and programme planning for prevention.
使用单一根本死因（UCoD）估算致命溺水事件可能会低估溺水死亡人数。本研究通过澳大利亚溺水死亡国家登记处，探讨了国际疾病分类（ICD）-10 编码组合和使用多种根本死因数据的变化情况。
对 2007-2011 年期间从澳大利亚皇家救生协会（该协会）开发的澳大利亚全人群非故意溺水数据库中提取的非故意溺水死亡的 ICD-10 外部原因代码进行分析。该研究针对三种报告方法分析了结果：主要溺水代码（W65-74）、溺水相关代码以及虽已识别溺水但未确定 UCoD 的情况。
澳大利亚，2007-2011 年。
非故意致命溺水病例。
数据库记录了 1428 例溺水死亡。866 例（60.6%）的 UCoD 为 W65-74（意外溺水），249 例（17.2%）的 UCoD 为 T75.1（0.2%）、V90（5.5%）、V92（3.5%）、X38（2.4%）或 Y21（5.9%），53 例（3.7%）缺乏 ICD 编码。儿童（0-17 岁）的情况与这一数据非常吻合（73.9%）；但在水上运动（29.2%）和非水上交通工具（13.0%）方面并非如此。当使用 UCoD 和所有后续原因时，67.2%的病例包含 W65-74 代码。所有病例中，91.6%的病例在任何级别均有溺水代码（T75.1、V90、V92、W65-74、X38 和 Y21）。
在澳大利亚，用 W65-74 代码定义溺水，并仅使用 UCoD 会导致 61%的溺水死亡被遗漏。这种方法的分布不均衡，成人、水上运动和与非水上交通工具相关的溺水死亡被低估。使用更广泛的 ICD 溺水相关代码和多种死因，可以最大程度地减少这种遗漏。对溺水死亡人数的狭义处理方法会对预防政策、宣传和规划方案的设计产生负面影响。
