# Presentation: 371850

## External Cause of Injury Mortality Matrix

**Lois A. Fingerhut on behalf on the **
**ICE on Injury Statistics**
**October 2004**

**Centers for Disease Control and Prevention**
**National 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 persons
Events 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

## External Cause of Injury Mortality Matrix

## 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)

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

## Relationship between ICECI and ICD-10 Chapter XX

## Questions?

- Lois Fingerhut
- US National Center for Health Statistics
- LFingerhut@cdc.gov