How are deaths from asthma recorded by doctors

What is it about?

In the UK, when someone dies, a record of their death is recorded by a medical practitioner .  Death records have multiple uses.  They legally state that  an individual has died (this will enable  lawyers and undertakers   to deal with the deceased’s  will, funeral and such).  These documents  are also used so that we can see how often people are dying from certain causes, and assess  how this changes over time. Within the record, the cause of death is given a short code of numbers and letters, based on a list of medical conditions called the International Classification of Diseases, or ICD.  New codes are added to the ICD with updates, including “newly identified diseases” like Covid-19.

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Why is it important?

Although there are strict guidelines on how codes should be decided, different codes may be assigned to the same cause of death, dependent upon who codes it, when the person died, how much of the person’s previous health information is known, and what tests were done in hospital, etc. When researchers are looking at death records over a big population or over a long time period, this possible difference in coding is very important to understand.  For example, if we compare how many people die from asthma in two different countries, the recording might be affected by which tests the doctors adopt to assess whether you have asthma in each country. In this study, we looked at how asthma deaths in Scotland were coded, and whether there has been any change over time in how they were recorded.  We used records for over 90,000 deaths between 2000 and 2017.  One in every 200 of these deaths were related to asthma. There are two main codes used for asthma – one labelled ‘asthma’ and one labelled ‘asthma attack’.  We found that usually when someone with asthma also had an infection in their lungs,  their death was recorded as ‘asthma’. Otherwise it was recorded as an ‘asthma attack’.

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