Norwegian Cause Of Death Registry Research Articles

Garbage codes in the Norwegian Cause of Death Registry 1996–2019

BackgroundReliable statistics on the underlying cause of death are essential for monitoring the health in a population. When there is insufficient information to identify the true underlying cause of death, the death will be classified using less informative codes, garbage codes. If many deaths are assigned a garbage code, the information value of the cause-of-death statistics is reduced. The aim of this study was to analyse the use of garbage codes in the Norwegian Cause of Death Registry (NCoDR).MethodsData from NCoDR on all deaths among Norwegian residents in the years 1996–2019 were used to describe the occurrence of garbage codes. We used logistic regression analyses to identify determinants for the use of garbage codes. Possible explanatory factors were year of death, sex, age of death, place of death and whether an autopsy was performed.ResultsA total of 29.0% (290,469/1,000,128) of the deaths were coded with a garbage code; 14.1% (140,804/1,000,128) with a major and 15.0% (149,665/1,000,128) with a minor garbage code. The five most common major garbage codes overall were ICD-10 codes I50 (heart failure), R96 (sudden death), R54 (senility), X59 (exposure to unspecified factor), and A41 (other sepsis). The most prevalent minor garbage codes were I64 (unspecified stroke), J18 (unspecified pneumonia), C80 (malignant neoplasm with unknown primary site), E14 (unspecified diabetes mellitus), and I69 (sequelae of cerebrovascular disease).The most important determinants for the use of garbage codes were the age of the deceased (OR 17.4 for age ≥ 90 vs age < 1) and death outside hospital (OR 2.08 for unknown place of death vs hospital).ConclusionOver a 24-year period, garbage codes were used in 29.0% of all deaths. The most important determinants of a death to be assigned a garbage code were advanced age and place of death outside hospital. Knowledge of the national epidemiological situation, as well as the rules and guidelines for mortality coding, is essential for understanding the prevalence and distribution of garbage codes, in order to rely on vital statistics.

Opioid related deaths in Norway in 2000–2019

AimsThe aim of the study is to present autopsy-based findings of the most prevalent opioids in overdose deaths in Norway from 2000 to 2019, as such data are lacking in the current literature. MethodsData on cause of death obtained from the Norwegian Cause of Death Registry (NCoDR) were linked with forensic toxicological results from forensic autopsies. ResultsFrom year 2000 the annual numbers of overdose deaths decreased, specifically during 2000–2003, thereafter a relatively stable annual number was observed. Opioids were detected in 93% of the cases. Heroin related deaths have decreased, whereas medical opioids for pain treatment have increased with time. Men in their early 40′s dominate the overall numbers of deaths, but significantly different sex patterns emerge when studying the specific drugs. During the past 20 years, the mean age at overdose death has increased by 10 years (from 33 to 43 years). Overdose deaths without any illicit drugs present at autopsy have increased in recent years. These deaths, where only potentially prescription medications were detected, were more common among women and with higher age. ConclusionsIn Norway during the past 20 years, we observe a dynamic shift in overdose deaths caused by heroin and illicit drugs, to include a gradually increasing trend of overdose deaths from pill based pain medications and also methadone and buprenorphine. This warrants a shift in preventive responses, as the target groups differ.

Lockdown and non-COVID-19 deaths: cause-specific mortality during the first wave of the 2020 pandemic in Norway: a population-based register study

ObjectiveTo explore the potential impact of the first wave of COVID-19 pandemic on all cause and cause-specific mortality in Norway.DesignPopulation-based register study.SettingThe Norwegian cause of Death Registry and the National...

Clinical Predictors for Reduced Long-Term Survival and Cause of Death after Curative Resection for Rectal Cancer

Purpose: To identify clinical predictors for reduced long-term survival and describe the cause of death after surgical treatment for rectal cancer. Methods: A retrospective follow-up study of 442 consecutive, unselected patients treated for rectal cancer at a tertiary centre from 1990 until 2000 and followed for 17 years or until death. Predictors for death were assessed by Cox regression analysis. The cause of death was obtained from the Norwegian Cause of Death Registry. Results: 254 men and 188 women with a median age of 71 years (21 - 95 years) were resected for rectal cancer with low anterior resection (n = 266), abdominoperineal resection (n = 125), Hartmann’s procedure (n = 19) or diverting stoma only (n = 32). Median follow-up was 5 years (0 - 17 years). The relative five-year survival rates for stages I, II, III and IV was 83.9%, 65.2%, 41.1% and 9.3%, respectively. The proportion of deaths due to recurrence from colorectal cancer in stages I, II, III and IV was 23.5%, 55.8%, 72.3% and 98.0%, respectively. Heart, lung and cerebrovascular disease and other malignancies were the cause of death in the other patients. Higher age, abdominoperineal resection compared to low anterior resection, lack of lymph node dissection compared to total mesorectal excision (TME), postoperative reoperations, TNM stages II and III compared to stage I and residual tumours after surgery were all significant independent predictors of reduced survival in the adjusted Cox regression model. Conclusions: Age, tumour stage, type of surgery, lymph node dissection, residual tumour after surgery and reoperations are predictors for survival after surgery for rectal cancer. In the patients who died, the cause of death was due to a condition other than colorectal cancer recurrence in 32.3% of the patients. The five-year relative survival rate was related to tumour stage.

Life expectancy and cause of death in individuals with haemophilia A and B in Norway, 1986-2018.

Evaluate trends over time in age- and cause of death in males with haemophilia (PWH) in Norway compared with the general male population and investigate its correlates with improvements in haemophilia treatment. Data about age and cause of death in the period of 1986-2018, from two independent, high-quality national registries: the Norwegian Cause of Death Registry (NCoDR) and the patient registry at Centre for Rare Disorders (CRD), Oslo University Hospital. Life expectancy increased significantly from 1986 to 2018. However, PWH still had a decreased mean age at death of 56.8years (SD=24.7) in the NCoDR and 58.6years (SD=21.7) in the CRD data, compared with 73.9years (SD=16.3) in the general male population. There was a distinct shift in the most frequently reported haemophilia-related causes of death, such as haemorrhage and AIDS, to more age-related causes of death, such as cancer, reflecting an ageing population. Haemophilia treatment has improved significantly in the last three decades. Despite treatment-related improvements, PWH in Norway still have a decreased life expectancy compared with the general male population.

Survival and death causes of patients with giant cell arteritis in Western Norway 1972\u20132012: a retrospective cohort study

BackgroundOur objective was to determine the survival and causes of death in a large and well-characterized cohort of patients with giant cell arteritis (GCA).MethodsThis is a hospital-based, retrospective, observational cohort study including patients diagnosed with GCA in Western Norway during 1972–2012. Patients were identified through computerized hospital records using the International Classification of Diseases (ICD)-coding system. Medical records were reviewed. Patients were randomly assigned population controls matched on age, sex, and geography from the Central Population Registry of Norway (CPRN). Date and cause of death were obtained from the Norwegian Cause of Death Registry (NCoDR). The survival was analyzed using Kaplan-Meier methods with the Gehan-Breslow test and the causes of death using cumulative incidence and Cox models for competing risks.ResultsWe identified 881 cases with a clinical diagnosis of GCA of which 792 fulfilled the American College of Rheumatology (ACR) 1990 classification criteria. Among those fulfilling the ACR criteria, 528 were also biopsy-verified. Cases were matched with 2577 population controls. A total of 490 (56%) GCA patients and 1517 (59%) controls died during the study period. We found no difference in the overall survival of GCA patients compared to controls, p = 0.413. The most frequent underlying causes of death in both groups were diseases of the circulatory system followed by cancer. GCA patients had increased risk of dying of circulatory disease (HR 1.31, 95% CI 1.13–1.51, p < 0.001) but lower risk of dying of cancer (HR 0.56, 95% CI 0.42–0.73, p < 0.001) compared to population controls.ConclusionsWe found no difference in the overall survival of GCA patients compared to matched controls, but there were differences in the distribution of underlying death causes.

Age at Death and Causes of Death in Patients with Huntington Disease in Norway in 1986–2015

Background:The literature offers discrepant findings regarding age at death in individuals with Huntington disease (HD).Objective:To study the age at death and causes of death in males and females with a diagnosis of HD in Norway.Methods:Registry study of deaths in 1986–2015 using data from two national registries: the Norwegian Cause of Death Registry (NCDR) and the registry of the Centre for Rare Disorders (CRD), Oslo University Hospital.Results:Mean age at death for individuals with HD was found to be 63.9 years (NCDR) and 61.7 years (CRD), compared to a mean of 76.9 years in the general population (NCDR). There were no significant gender differences for age at death in individuals with HD. The significant increase in age at death within the general population from 1986 to 2015 was not observed in individuals with HD. In 73.5% of individuals with HD, the underlying cause of death was HD, followed by cardiovascular diseases, cancer and respiratory diseases. The most common immediate cause of death was respiratory diseases (44.2%). Suicide was a more common cause of death in the population with HD (2.3%) compared to the general population (1.3%).Conclusion:The age at death of individuals with HD was stable over a period of 30 years and 13.3 years lower than in the general population. Longer life expectancy for females from the general population was not found in females with HD. Suicide was more common among individuals with HD compared to the general population.

Abstract 19275: Gender Differences in Cardiovascular- and Cancer Mortality During Long-term Follow-up After Acute Myocardial Infarction

Background: The existence of gender differences in cause-specific mortality after acute myocardial infarction (AMI) is unknown. Aim: To study gender differences in all-cause and cause-specific mortality in women and men with AMI. Methods: Consecutive AMI patients were enrolled in a prospective cohort study during 2005-2011. Cardiovascular (CV) risk factors, treatment and in-hospital complications were registered. Date and cause of death were obtained from the Norwegian cause of death registry, with censoring date set to Dec 31, 2012. Patients with ST-elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI) were analysed separately. We used Kaplan Meier- and cumulative incidence function-plots to assess gender differences in CV, cancer and all-cause mortality. Cox- and Fine-Gray regression models, adjusted for age, estimated the effect of female gender. Results: We included 5159 NSTEMI (34% women) and 4899 STEMI (25% women) patients. Women were older and had more complications compared to men. After a median follow-up time of 1043 and 1262 days for NSTEMI and STEMI, respectively, 1461 NSTEMI (28%) and 886 STEMI (18%) patients had died. After adjustment for age, NSTEMI women had lower (HR 0.89 [95% CI: 0.80-0.99]) and STEMI women similar (HR 1.05 [95% CI: 0.91-1.22]) risk of all-cause mortality compared to men. There were no gender differences in CV mortality. We observed a non-significant trend toward lower cancer mortality in women than men with NSTEMI (adjusted subhazard ratio 0.76 [95% CI:0.56-1.03]). In both genders, CV death was more prevalent (Figure) and occurred earlier than cancer death. Conclusion: After adjustment for age, there were no excess risks of all-cause or CV mortality in women versus men with AMI during long-term follow-up. Possible gender differences in risk of cancer mortality needs further investigation.