The Czech Republic Annual Report 2010 Drug ... - Drogy-info.cz

diagnoses listed under letters X or Y with diagnoses for poisoning caused by the given substance – a narcotic or
psychodysleptic drug (dg. T40 and T43.6). In 2010, an alternative selection was made from the death statistics for
the first time. In the alternative selection, a combination with a T diagnosis for substances is not necessary for
accidental, intentional, or undetermined poisonings caused by narcotics and psychodysleptic drugs (X42, X62 and
Y12). The disadvantage of the alternative selection is that without the substance code, no differentiation can be
made between the individual types of drugs which cause the fatal overdose.
At the end of 2010, the National Focal Point’s working group for drug-related deaths agreed that the National Focal
Point and the Institute of Health Information and Statistics would collaborate in comparing individual cases of drug
deaths extracted from the special mortality register and the general mortality register in 2009. In the analysis,
diagnoses of the causes of death from the Death Certificate information system were added to the data from these
registers 98 . Cases from the special register with data from the Information System of Deaths and the Death
Certificate information system added served as the basis of the analysis. Data could not be found for seven cases
from the special register (out of 49 deaths found in 2009) either in the Information System of Deaths or in the Death
Certificate information system, which could be because the Death Certificate for these deaths was not completed or
because there are errors in the personal identification number (birth number) or code in the special register. In twelve
cases the records were connected and the substances that caused death were identical. In seven cases a different
substance was stated in the Information System of Deaths than in the special register, and in 15 cases diagnoses
were stated in the Information System of Deaths which did not fall under selection B 99 .
The remaining eight cases of death in the special register related to inhalant overdoses. These are not included in
selection B. In an effort to bring selection B from the general register as close to selection D from the special mortality
register as possible, standard selection B was expanded to include inhalants, i.e. dg. F18 (a mental disorder or
behavioural disorder caused by the use of inhalants) and dg. X46, X66 and Y16 in combination with dg. T52, i.e.
accidental, intentional, or undetermined poisoning caused by inhalants.
The structure of fatal drug overdoses in 2010 according to the standard and expanded EMCDDA selection B by age,
gender, and type of drug is provided in Table 6-16 and trends for deaths by individual drugs are provided in Table
6-17 (Ústav zdravotnických informací a statistiky, 2011b).
Table 6-16: Fatal drug overdoses in the Czech Republic in 2010 according to selection B and expanded selection B in the general
mortality register by groups of drugs, age groups, and gender (Ústav zdravotnických informací a statistiky, 2011b)
Total
Drug
64
Males
Females Total
Opiates/opioids 0 3 2 2 1 1 1 0 1 1 1 0 10 3 13
Cannabis 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Cocaine 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Other stimulants 0 0 1 2 3 1 1 0 0 0 0 0 8 0 8
Hallucinogens 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Drugs not further
specified
0 0 3 1 1 1 0 1 1 0 0 0 7 1 8
Selection B
(standard)
0 3 6 5 5 3 2 1 2 1 1 0 25 4 29
Inhalants 0 0 2 2 1 3 3 0 2 0 0 0 10 3 13
Selection B
(expanded)
0 3 8 7 6 6 5 1 4 1 1 0 35 7 42
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The Institute of Health Information and Statistics manages and processes this information system to quickly and flexibly select deaths
with certain characteristics (e.g. to retrieve death cases for the National Cancer Register), to be able to monitor comorbidities based on
cause of death diagnoses, to satisfy the needs of healthcare facilities in updating registers and files, etc. The Certificate of Post-Mortem
Examination contains the primary cause of death and previous causes and diseases that directly led to the death, as well as serious
pathological findings that were a contributing cause of death and external causes of death.
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These differences were caused in part by the changes in the diagnoses not being reported to the forensic medicine departments after
the result of the toxicological examination was known, and by errors in the cause of death code at the Czech Statistical Office. On the
basis of these findings, a recommendation was made to the Czech Statistical Office to check the codes of drug-related deaths in
accordance with the International Classification of Diseases instruction manual, which described the procedures for coding poisonings
from pharmaceuticals, medications, and addictive and biological substances. The Czech Statistical Office stated that these checks were
implemented in the course of 2010. Furthermore, representatives of the Czech Society for Forensic Medicine and Toxicology were
acquainted with the results of the analysis and asked to complete the Certificate of Post-Mortem Examination correction reports more
thoroughly.
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