TY - JOUR
T1 - Reporting of alcohol as a contributor to death in Australian national suicide statistics and its relationship to post-mortem alcohol concentrations
AU - Chitty, Kate M.
AU - Schumann, Jennifer L.
AU - Moran, Lauren L.
AU - Chong, Daniel G.
AU - Hurzeler, Tristan P.
AU - Buckley, Nicholas A.
N1 - Funding Information:
We would like to thank the National Coronial Information System (NCIS), which is managed by the Victorian Department of Justice and Community Safety, and the Australian Bureau of Statistics. We would also like to thank the Research Assistants who have helped us to extract and code the data used in this project; Laura Zark, Stephanie Ivezic, Ashley Stewart, Melissa Robinson and Amy Hatfield. An Australian National Health and Medical Research Council (NHMRC) Program Grant supported this work (1055176). An NHMRC Early Career Fellowship funds K.C. (1122362). The funding organization played no part in the design and conduct of the study; collection, management, analysis, and interpretation of the data; nor in the preparation, review, or approval of the manuscript. Kate Chitty: Conceptualization; data curation; formal analysis; funding acquisition; investigation; methodology; project administration. Jennifer Schumann: Conceptualization; data curation; project administration. Lauren Moran: Data curation; methodology. Daniel Chong: Data curation. Tristan Hurzeler: Conceptualization. Nicholas Buckley: Conceptualization; investigation; supervision.
Funding Information:
We would like to thank the National Coronial Information System (NCIS), which is managed by the Victorian Department of Justice and Community Safety, and the Australian Bureau of Statistics. We would also like to thank the Research Assistants who have helped us to extract and code the data used in this project; Laura Zark, Stephanie Ivezic, Ashley Stewart, Melissa Robinson and Amy Hatfield. An Australian National Health and Medical Research Council (NHMRC) Program Grant supported this work (1055176). An NHMRC Early Career Fellowship funds K.C. (1122362). The funding organization played no part in the design and conduct of the study; collection, management, analysis, and interpretation of the data; nor in the preparation, review, or approval of the manuscript.
Publisher Copyright:
© 2020 Society for the Study of Addiction
PY - 2021/3
Y1 - 2021/3
N2 - Aim: To describe the assignment of International Classification of Disease (ICD)-10 alcohol codes as underlying or contributory causes of death by the Australian Bureau of Statistics during mortality coding for suicides according to the blood alcohol concentration (BAC) detected at autopsy. Design: Population-based case-series descriptive analysis. Setting and participants: Data for all alcohol-related (Alc+) suicide deaths (aged 15+) in Australia from 2010–2015 (n = 3132) from the National Coronial Information System. Measurements: Alc+ suicides were categorised as those with a post-mortem BAC ≥0.05 g/100 mL. The outcome variable was whether the case was assigned an ICD-10 alcohol code (F10.0–F10.9, R78.0, T51, X45 and/or X65). We estimated OR for the assignment of codes in Alc+ suicides using BAC as the key predictor. We also examined several covariates that have been implicated in the risk of Alc+ suicides. Findings: An ICD-10 alcohol code was assigned during the mortality coding process in 47.6% (n = 1491) of Alc+ suicides. Higher BAC was associated with higher odds of having a code assigned; cases with a BAC over 0.20 g/100 mL over were twice as likely to have an alcohol code assigned (adjusted OR [AOR] = 2.06, 95% CI = 1.59, 2.67) compared with cases with a BAC of 0.050–0.075 g/100 mL. Compared with New South Wales, higher likelihood of code assignment was found in Northern Territory (AOR = 3.85, 95% CI = 2.32, 6.63) and Western Australia (AOR = 2.89, 95% CI = 2.27, 3.68). Compared with 15–24 year olds, 25–44 (AOR = 0.79, 95% CI = 0.63, 0.99) and 65–84 year olds (AOR = 0.63, 95% CI = 0.43, 0.93) were less likely to have a code assigned. Conclusions: An ICD-10 alcohol code was not assigned as an underlying or contributory cause of death in over half of suicides in Australia (2010–2015) with a BAC ≥0.05 g/100 mL. The higher the BAC detected at autopsy, the more likely cases were to be assigned an alcohol code during the mortality coding process.
AB - Aim: To describe the assignment of International Classification of Disease (ICD)-10 alcohol codes as underlying or contributory causes of death by the Australian Bureau of Statistics during mortality coding for suicides according to the blood alcohol concentration (BAC) detected at autopsy. Design: Population-based case-series descriptive analysis. Setting and participants: Data for all alcohol-related (Alc+) suicide deaths (aged 15+) in Australia from 2010–2015 (n = 3132) from the National Coronial Information System. Measurements: Alc+ suicides were categorised as those with a post-mortem BAC ≥0.05 g/100 mL. The outcome variable was whether the case was assigned an ICD-10 alcohol code (F10.0–F10.9, R78.0, T51, X45 and/or X65). We estimated OR for the assignment of codes in Alc+ suicides using BAC as the key predictor. We also examined several covariates that have been implicated in the risk of Alc+ suicides. Findings: An ICD-10 alcohol code was assigned during the mortality coding process in 47.6% (n = 1491) of Alc+ suicides. Higher BAC was associated with higher odds of having a code assigned; cases with a BAC over 0.20 g/100 mL over were twice as likely to have an alcohol code assigned (adjusted OR [AOR] = 2.06, 95% CI = 1.59, 2.67) compared with cases with a BAC of 0.050–0.075 g/100 mL. Compared with New South Wales, higher likelihood of code assignment was found in Northern Territory (AOR = 3.85, 95% CI = 2.32, 6.63) and Western Australia (AOR = 2.89, 95% CI = 2.27, 3.68). Compared with 15–24 year olds, 25–44 (AOR = 0.79, 95% CI = 0.63, 0.99) and 65–84 year olds (AOR = 0.63, 95% CI = 0.43, 0.93) were less likely to have a code assigned. Conclusions: An ICD-10 alcohol code was not assigned as an underlying or contributory cause of death in over half of suicides in Australia (2010–2015) with a BAC ≥0.05 g/100 mL. The higher the BAC detected at autopsy, the more likely cases were to be assigned an alcohol code during the mortality coding process.
KW - Alcohol
KW - epidemiology
KW - forensic toxicology
KW - mortality coding
KW - policy
KW - suicide
UR - http://www.scopus.com/inward/record.url?scp=85089075872&partnerID=8YFLogxK
U2 - 10.1111/add.15180
DO - 10.1111/add.15180
M3 - Article
C2 - 32621553
AN - SCOPUS:85089075872
SN - 0965-2140
VL - 116
SP - 506
EP - 513
JO - Addiction
JF - Addiction
IS - 3
ER -