The information requested falls within the responsibility of the UK Statistics Authority. I have asked the authority to reply.
Letter from Stephen Penneck, dated March 2010:
As Director General for the Office for National Statistics, I have been asked to reply to your recent question asking how many death certificates which mentioned thrombosis have been issued in each of the last five years. (322541)
Internationally accepted guidance from the World Health Organisation requires only those conditions that contributed directly to death to be recorded on the death certificate. Medical practitioners and coroners are not supposed to record all of the diseases or conditions present at or before death. Whether a condition contributed is a matter for their clinical judgement.
The table attached provides the number of deaths where the International Classification of Diseases, Tenth Revision (ICD-10) codes recorded indicate whether any of the following conditions were mentioned anywhere on the death certificate, either as the underlying cause or as a contributory factor, in England and Wales, for 2004 to 2008 (the latest year available).
(a) Myocardial infarction and coronary thrombosis
(b) Thrombotic strokes
(c) Pulmonary embolism and deep vein thrombosis
(d) Arterial embolism and thrombosis
It is not possible from death certificate data to separate thrombotic, embolic and atherosclerotic conditions affecting the arteries to the brain. Atherosclerosis of arteries in the neck and inside the skull can lead to strokes through thrombosis, embolism or sometimes haemorrhage. The table therefore includes a single category of deaths with mention of one or more ICD codes in the range that includes thrombotic, embolic and atherosclerotic cerebrovascular diseases. Pulmonary embolism and venous thrombosis have been combined, because when one is part of the sequence leading to death, the other nearly always is as well, whether it is mentioned on the certificate or not.
When interpreting the data in these tables, it is important to be aware that some deaths may have more than one of the requested conditions mentioned. Therefore, some deaths may be counted in more than one of the causes listed.
Deaths (persons) Cause 2004 2005 2006 2007 2008 Myocardial infarction and coronary thrombosis 44,283 41,446 38,159 36,152 34,159 Thrombotic strokes 505 457 385 301 290 Pulmonary embolism and deep vein thrombosis 12,387 12,254 12,683 12,347 12,611 Arterial embolism and thrombosis 517 518 517 501 537 1 Cause of death was defined using the International Classification of Diseases, Tenth Revision (ICD-10). The specific causes of death categorised in Table 1, and their corresponding ICD-10 codes, are shown in the following box. Deaths were included where one of these causes was mentioned anywhere on the death certificate. 2 Figures for England and Wales include deaths of non-residents. 3 Figures are for deaths registered in each calendar year.
Cause of death ICD-10 code(s) Myocardial infarction and coronary thrombosis I21-I24.0 Thrombotic Strokes I63.0, I63.3, I63.6, I65-I66 Pulmonary embolism and deep vein thrombosis I80.1-I80.3, I80.9, I82.9, I26.0, I26.9 Arterial embolism and thrombosis I74