O-22 Garbage Codes as Underlying Causes of Out-of-Hospital Deaths in East Trinidad, 2022-2023

Methods: Cross sectional study was performed.Data on deaths occurring in the communities of East  Trinidad  from January 2022–August 2023 were reported by District Medical Officers. Variables collected were the address of deceased, date of birth, date of death, age at death, sex, ethnicity, medical cause of death, post mortem requested and the  county at  which  the  deceased  body was located. The medical cause of death was coded into ICD 11 and classified as garbage codes using WHO Digital Open Rule Integrated cause of death Selection. Data was analysed using Excel® version 2108, SPSS® version 27. 

Results: Of the reported 150 deaths, 85 (56.7%) were male and 64 (42.7%) were female. The mean age was 66.3 years (SD19.8 years). The most common underlying cause of death  included Cardiopulmonary  arrest (11.6%), Brought-in-Dead (10.3%), Diabetes Mellitus (6.8%) and Certififed (6.2%). Lack of  specificity, abbrevations, use of immediate and intermedite causes of death were noted. Of the underlying cause of death, 70 (46.3%) were garbage codes such as Brough-in-Dead (10.3%), Cardiopulmonary Arrest (n=7) , Certified (n=9), Indeterminate Natural Cause (n=3), Myocardial Infarction (n=3) and (n<3): Kidney Failure Unspecified, Maliagant neoplasms of colon unspecified, Epilepsy. 31 (44.3%) decendents with garbage codes were subseqently referred for post mortem.

Conclusion: There is a need to improve the quality of data reported as medical cause of deaths to accurately inform on burden of diseases and population statistics in a community. Using automated ICD-11 software can assist public health policy makers in deciphering garbage codes.