title: Reporting of aspiration pneumonia or choking as a cause of death in patients who died with stroke.
abstract: OBJECTIVE
  It is not known how many stroke patients die from fatal pulmonary complications such as aspiration pneumonia (AP) and choking each year in the United States. This study aimed to determine the frequency of reporting of AP or choking as a cause of death on death certificates with mention of stroke in the United States as a proxy measure of the incidence of dying from AP or choking among patients with stroke.
  
  
  METHODS
  We used multiple-cause mortality data for the years 2001 to 2010 to identify death certificates with mention of stroke (International Classification of Diseases, Tenth Revision code I60-I69), AP (International Classification of Diseases, Tenth Revision code J69), and choking (International Classification of Diseases, Tenth Revision code W78-W80) for analysis.
  
  
  RESULTS
  Of 2 424 379 death certificates with mention of stroke in the United States between 2001 and 2010, 5.1% (n=124 503) reported AP as a cause of death, and 1.5% (n=36 997) reported choking as a cause of death. However, if we confined the analysis to autopsy-confirmed cases, the frequency decreased to 1.3% (555/42 732) and 1.3% (541/42 732), respectively. The adjusted odds ratios of reporting AP or choking as a cause of death were higher among men, increased with age, and were higher among decedents who died in a nursing home/long-term care.
  
  
  CONCLUSIONS
  The estimated incidence of dying from AP and choking among patients who died with stroke was 5% (~12 000 deaths per year) and 1% (~3700 deaths per year) according to information reported on death certificates. Efforts are needed to reduce the number of deaths from these 2 preventable complications.
authors: Department of Neurology, Chi Mei Medical Center, Tainan, Taiwan.
authors: Chia-Yu
authors: CY
authors: Chang
authors: Tain-Junn
authors: TJ
authors: Cheng
authors: Ching-Yih
authors: CY
authors: Lin
authors: Jen-Yin
authors: JY
authors: Chen
authors: Tsung-Hsueh
authors: TH
authors: Lu
authors: Ichiro
authors: I
authors: Kawachi
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000402:Airway Obstruction / Q000150:complications / Q000175:diagnosis* / Q000401:mortality; D002423:Cause of Death; D003644:Death Certificates; D005260:Female; D006801:Humans; D015994:Incidence; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011015:Pneumonia, Aspiration / Q000150:complications / Q000175:diagnosis* / Q000401:mortality; D012737:Sex Factors; D020521:Stroke / Q000150:complications / Q000401:mortality*; D014481:United States