The use of cardiovascular modes of death in the office of national statistics mortality statistics

Abstract

Abstract Funding Acknowledgements: Type of funding sources: Other. Main funding source(s): Cardiac Risk in the Young The office for national statistics (ONS) holds a record of all causes of death in England and Wales according to the International Classification of Diseases 10th Revision. In some cases, a mode of death, such as arrhythmia, may be given. We aimed to quantify the proportion of cardiovascular deaths being coded as a mechanism of death from the ONS. We analysed the ONS records from 2013 – 2021. There were 4,852,897 deaths overall, of which, 836,741 (17.24%) were cardiovascular. Of these, 103,160 (12.33%) were labelled as mechanisms and 35,784 (4.28%) were nonspecific causes. The most common modes being used were arrhythmia (56,291 (6.7%)) and heart failure (46787 (5.6%)). The most common nonspecific codes being used were myocardial degeneration (12,192 (1.46%)), unascertained (10,605 (1.27%)) and cardiomegaly (6,573 (0.79%)). Modes of death as opposed to causes of death are being used in a notable proportion of cardiac deaths and this is increasing. Modes of death do not aid in screening of blood relatives for inherited cardiac conditions. Causes should be listed as an underlying disease process such as ischaemic heart disease (IHD) or hypertrophic cardiomyopathy. This enables screening to be focussed on specific diseases. The use of a mode of death as opposed to a specific disease should prompt a referral for autopsy. ICD-11 has coding for SADS and arrhythmogenic cardiomyopathy (ACM) and our findings highlight the importance of the transition to this update to allow accurate establishment of the burden of disease of these two important genetic conditions.