Hidden respiratory disease-associated deaths.
OBJECTIVE
To bring together all deaths of respiratory origin, whether concentrated under Group J of the International Classification of Diseases (ICD-10) or in other codes, and including the upper and lower airways and thorax, for a more accurate assessment of the public importance of respiratory diseases.


METHODS
The most recent disaggregated mortality database (data from 86 countries) available from the World Health Organization using the ICD-10 was reviewed.


RESULTS
Respiratory problems caused 16.6% of the deaths in the countries analysed (95%CI 7.9-27.1); 61% were considered chronic respiratory ailments (95%CI 17-85). Of all respiratory-related deaths, 44% were outside Group J and 7.8% were hidden in codes other than J, thoracic tumours, tuberculosis and diseases of pulmonary circulation. Hidden respiratory deaths were more common in low-income countries, but approximately 5% of respiratory deaths in high-income countries were also hidden. Respiratory deaths were the leading cause of death in five countries even when compared to the total number of cardiovascular and cancer deaths.


CONCLUSIONS
A significant proportion of respiratory deaths are 'hidden' in several ICD-10 codes, and are more numerous in countries with a high rate of acute respiratory disease and a low rate of chronic respiratory disease.
Perez-Padilla
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National Institute of Respiratory Diseases of Mexico, Tlalpan, México. perezpad@servidor.unam.mx
D017281:Cost of Illness; D014943:Global Health; D006801:Humans; D038801:International Classification of Diseases; D012140:Respiratory Tract Diseases / Q000145:classification / Q000175:diagnosis / Q000401:mortality*; D012959:Socioeconomic Factors