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Clostridium Difficile

Treasury written question – answered on 16th January 2007.

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Photo of Andrew Lansley Andrew Lansley Shadow Secretary of State for Health

To ask the Chancellor of the Exchequer how many death certificates mentioning clostridium difficile as an (a) primary and (b) secondary cause of death there have been in each year since 1997.

Photo of John Healey John Healey The Financial Secretary to the Treasury

The information requested falls within the responsibility of the National Statistician who has been asked to reply.

Letter from Karen Dunnell, dated 16 January 2007:

As National Statistician I have been asked to reply to your recent Parliamentary Question asking how many death certificates mentioning clostridium difficile as a (a) primary and (b) secondary cause of death there have been in each year since 1997. (115026)

Special analyses of deaths involving Clostridium difficile are undertaken annually by the Office for National Statistics (ONS) for England and Wales. These are published in Health Statistics Quarterly. The latest year for which such figures are available is 2004. Information on the numbers of deaths between 1999 and 2004 involving C. difficile was published in Health Statistics Quarterly 30 in May 2006.(1)

This report presents data for the number of death certificates which (a) mention C. difficile and (b) list C. difficile as the underlying cause of death. The table below is extracted from this report:

Number of death certificates in England and Wales which (i) mentioned clostridium difficile( 1) and (ii) listed Clostridium difficile as the underlying cause of death( 2) in 1999 and 2001-04( 3)
(i) Certificates mentioning C. difficile (ii) Certificates where C. difficile was the underlying cause of death
1999 975 531
2001 1,214 691
2002 1,428 756
2003 1,788 958
2004 2,247 1,245
(1) Identified using the methodology described in Office for National Statistics (2005) Report: Deaths involving Clostridium difficile: England and Wales, 1999-2004. "Health Statistics Quarterly" 30, 56-60.

(2) Excludes neonatal deaths.

(3) Deaths registered in 1999, deaths occurring in 2001-04.

All deaths in England and Wales are coded by the ONS according to the International Classification of Diseases (ICD). The Tenth revision (ICD-10) has been used by the ONS since 2001. In the Ninth revision of the ICD (ICD-9) there are no specific codes that would allow deaths mentioning C. diff to be easily identified. Identifying these deaths in ICD-9 would require extensive text searching of a very large number of death certificates. This could only be done at disproportionate cost. Data for 1997, 1998 and 2000 are therefore not available as ICD-9 was used in these years.

Deaths registered in 1999 in England and Wales were coded to both ICD-9 and ICD-10 as part of a special study to compare the two ICD revisions, and have therefore been used to give an additional year of data on deaths involving C. diff.

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