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Evaluation of Oklahoma’s Electronic Death Registration System and Event Fatality Markers for Disaster-Related Mortality Surveillance – Oklahoma USA, May 2013

Published online by Cambridge University Press:  03 May 2019

Anindita N. Issa ,
Kelly Baker ,
Derek Pate ,
Royal Law ,
Tesfaye Bayleyegn  and
Rebecca S. Noe
Anindita N. Issa*
Affiliation:
Centers for Disease Control and Prevention, Chamblee, Georgia, USA
Kelly Baker
Affiliation:
Oklahoma State Department of Health, Oklahoma City, Oklahoma, USA
Derek Pate
Affiliation:
Oklahoma State Department of Health, Oklahoma City, Oklahoma, USA
Royal Law
Affiliation:
Centers for Disease Control and Prevention, Chamblee, Georgia, USA
Tesfaye Bayleyegn
Affiliation:
Centers for Disease Control and Prevention, Chamblee, Georgia, USA
Rebecca S. Noe
Affiliation:
Centers for Disease Control and Prevention, Chamblee, Georgia, USA
*
Correspondence: Anindita N. Issa, MD, Centers for Disease Control and Prevention, National Center for Environmental Health, 4770 Buford Hwy, NE, MS F-60, Chamblee, Georgia 30341 USA E-mail: aissa@cdc.gov
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Abstract

Introduction:

Official counts of deaths attributed to disasters are often under-reported, thus adversely affecting public health messaging designed to prevent further mortality. During the Oklahoma (USA) May 2013 tornadoes, Oklahoma State Health Department Division of Vital Records (VR; Oklahoma City, Oklahoma USA) piloted a flagging procedure to track tornado-attributed deaths within its Electronic Death Registration System (EDRS). To determine if the EDRS was capturing all tornado-attributed deaths, the Centers for Disease Control and Prevention (CDC; Atlanta, Georgia USA) evaluated three event fatality markers (EFM), which are used to collate information about deaths for immediate response and retrospective research efforts.

Methods:

Oklahoma identified 48 tornado-attributed deaths through a retrospective review of hospital morbidity and mortality records. The Centers for Disease Control and Prevention (CDC; Atlanta, Georgia USA) analyzed the sensitivity, timeliness, and validity for three EFMs, which included: (1) a tornado-specific flag on the death record; (2) a tornado-related term in the death certificate; and (3) X37, the International Classification of Diseases, 10th Revision (ICD-10) code in the death record for Victim of a Cataclysmic Storm, which includes tornadoes.

Results:

The flag was the most sensitive EFM (89.6%; 43/48), followed by the tornado term (75.0%; 36/48), and the X37 code (56.2%; 27/48). The most-timely EFM was the flag, which took 2.0 median days to report (range 0-10 days), followed by the tornado term (median 3.5 days; range 1-21), and the X37 code (median >10 days; range 2-122). Over one-half (52.1%; 25/48) of the tornado-attributed deaths were missing at least one EFM. Twenty-six percent (11/43) of flagged records had no tornado term, and 44.1% (19/43) had no X37 code. Eleven percent (4/36) of records with a tornado term did not have a flag.

Conclusion:

The tornado-specific flag was the most sensitive and timely EFM. Using the flag to collate death records and identify additional deaths without the tornado term and X37 code may improve immediate response and retrospective investigations. Moreover, each of the EFMs can serve as quality controls for the others to maximize capture of all disaster-attributed deaths from vital statistics records in the EDRS.

Issa AN, Baker K, Pate D, Law R, Bayleyegn T, Noe RS. Evaluation of Oklahoma’s Electronic Death Registration System and event fatality markers for disaster-related mortality surveillance – Oklahoma USA, May 2013. Prehosp Disaster Med. 2019;34(2):125–131

Keywords

disasterEDRSflagmortalitytornado
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 34 , Issue 2 , April 2019 , pp. 125 - 131
Copyright
© World Association for Disaster and Emergency Medicine 2019 

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Footnotes

Conflicts of interest: none

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