[Coding practice in fatal poisonings].
BACKGROUND
Each year, nearly 100 deaths and more than 10,000 admissions to Norwegian hospitals can be attributed to acute poisoning from non-medical substances and drugs in supra-therapeutic doses. The aim of this study was to evaluate hospitals' routines for coding of acute poisoning deaths and to provide information on the toxic agents involved.


METHODS
Medical records of deaths (at 6 Norwegian hospitals in the period 1.1.1999 -31.12.2005) due to acute poisoning were re-examined to assess accuracy of diagnosis codes.


RESULTS
Acute poisoning was registered as the cause of 225 deaths in the study period. The re-evaluation concluded that 45 of these deaths had other causes. In 125 of the remaining 180 deaths, acute poisoning was only registered as a side diagnosis, although re-examination revealed it was the major contribution to death in 66 % (83 of 125) of cases. The hospitals had classified the drugs according to ATC codes in 16 % (28 of 180) of patients with acute poisoning.


CONCLUSIONS
The present Norwegian coding practice does not document acute poisoning deaths in hospital correctly, and registry studies based on diagnosis codes should be interpreted with care. Current registration of poisoning agents' ATC-codes is insufficient and the Norwegian version of ICD-10 alone is not suitable for classification of acute drug poisoning. Replacement of the Norwegian ICD-10 version by the original international version should be considered and/or the routines for registration of ATC-codes should be improved.
Muan
Berit
B
Avdeling giftinformasjon, Helsedirektoratet, Postboks 7000 St. Olavs plass, 0130 Oslo, Norway. berit.muan@helsedir.no
Heyerdahl
Fridtjof
F
Lindås
Roald
R
Prestmo
Anders
A
Skjønsberg
Helge
H
Berg
Knut Joachim
KJ
D000208:Acute Disease; D000328:Adult; D000368:Aged; D002423:Cause of Death; D062787:Drug Overdose / Q000145:classification / Q000175:diagnosis / Q000401:mortality; D017052:Hospital Mortality; D006801:Humans; D038801:International Classification of Diseases; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D004364:Pharmaceutical Preparations / Q000145:classification; D011041:Poisoning / Q000145:classification* / Q000175:diagnosis / Q000401:mortality; D012042:Registries; D012189:Retrospective Studies; D013405:Suicide / Q000145:classification
D004364:Pharmaceutical Preparations