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Trends in gastroenteritis-associated mortality in the United States, 1985–2005: variations by ICD-9 and ICD-10 codes
Open accessAbstract
BACKGROUND: Trends in gastroenteritis-associated mortality are changing over time with development of antibiotic resistant strains of certain pathogens, improved diagnostic methods, and changing healthcare. In 1999, ICD-10 coding was introduced for mortality records which can also affect trends. We assess trends in gastroenteritis-associated mortality and changes associated with coding. METHODS: Trends in gastroenteritis-associated mortality rates in the United States were examined using the National Center for Health Statistics Multiple Cause-of-Death Mortality databases for 1985-2005. All deaths with the underlying cause or any contributing cause included gastroenteritis were included. Cases were selected based on ICD9 (pre-1999) and ICD10 (1999-2005) codes and all analyses were stratified by ICD usage. Annual trends in age adjusted mortality rates were assessed using linear regression spline analysis. Relative risks and 95% confidence intervals (CIs) were calculated using Poisson regression adjusted for age group, sex, race, and region. RESULTS: There were a total of 190,674 deaths related to gastroenteritis in the U.S. from 1985-2005 with an average of 9,080 per year. During this time the percent of deaths related to gastroenteritis more than tripled, increasing from 0.25% to 0.80% of all deaths. Though the time periods varied in length, we demonstrate a significant increase in slope from a 0.0054% annual increase during the period 1985-1998, when ICD-9 coding was used, to a 0.0550% annual increase during 1999-2005, when ICD-10 coding was used. For both time periods, the oldest age group (75+ years) demonstrated the highest risk of death due to gastroenteritis. Additionally, males demonstrated higher risk than females and blacks were at higher risk than whites for death due to gastroenteritis. CONCLUSIONS: This analysis demonstrates the public health burden of gastroenteritis-associated mortality in the United States and changes in trends due to change from ICD-9 to ICD-10 coding. The overall rate of gastroenteritis-associated mortality has more than tripled over the 21-year period from 1985 to 2005 and the primary burden of deaths due to gastroenteritis is in the elderly population.
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Changes in versions of code classification systems (e.g., from ICD-9 to ICD-10) may alter the validity of ascertainment using coded data.
“In addition, changes in versions of code classification systems (e.g., from International Classification of Diseases (ICD)-9 to ICD-10) may alter the validity of ascertainment using coded data [65,66].”
From The Reporting of Studies Conducted Using Observational Routinely-Collected Health Data (RECORD) statement. (2015) · cites this paper as [66]
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Metadata
- Authors
- Jagai, J. S., Smith, G. S., Schmid, J. E., & Wade, T. J.
- Affiliations
- Environmental Protection Agency (US)
- Corresponding author
- Jagai, Jyotsna S
- Venue
- BMC Gastroenterology
- Published
- 2014-12
- Volume
- 14
- Issue
- 1
- Pages
- 211-211
- ISSN
- 1471-230X (ISSN-L)
- PMC
- PMC4267146
- OpenAlex
- W1985581822
- Cited by
- 25
- References
- 21
- Citations by year
- 2026: 2 · 2025: 2 · 2023: 3 · 2022: 3 · 2021: 3 · 2020: 2 · 2019: 3 · 2017: 4 · 2016: 1 · 2015: 2
- FWCI
- 1.63
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- BMC Gastroenterology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Carolina Digital Repository (University of North Carolina at Chapel Hill) (submittedVersion)
- UNC Libraries
- Topics
- Health Sciences › Medicine › Infectious Diseases › Viral gastroenteritis research and epidemiology
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Global Health and Epidemiology
- Life Sciences › Agricultural and Biological Sciences › Food Science › Salmonella and Campylobacter epidemiology
- Keywords
- gastroenteritis, mortality trends, ICD-10, ICD-9, age-adjusted mortality rates, older adults, sex differences, racial disparities, public health burden, antibiotic-resistant pathogens, diagnostic advances
- MeSH terms
- Black or African American, Female, Gastroenteritis, Humans, Male, Sex Factors, United States, International Classification of Diseases, Black People, White People
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