How can the national burden of XXXX comorbidity and mortality be estimated for the Japanese population?

@entity1 @entity66 @entity6 @entity303 @entity5 @entity72987 @entity191 @entity74 @entity299 @entity204
BACKGROUND: Good medical care results in long survival for @entity1 with @entity191 ( @entity191 ). However, little is known about the burden of @entity191 comorbidity and mortality in Japan. This is the first study to examine comorbid diseases of @entity191 decedents and extrapolate @entity191 @entity204 rates from multiple-cause coding mortality data for the total population of Japan. METHODS: Data for 4589 certified deaths due to @entity191 as the underlying cause of @entity204 (ICD-10 code: @entity72987 ) were obtained from the 2008 Japanese vital statistics. Of those, comorbidities listed in the @entity204 certificates of 477 randomly selected decedents were analyzed. All @entity74 mentioned on @entity204 certificates were counted and ranked in descending order of frequency. The @entity204 rates (per 100,000 population) from @entity191 were calculated using Japanese National Vital Statistics. The estimated rate of deaths with @entity191 was extrapolated using US @entity204 data from a multiple-cause coding system, as no such system is available in Japan, with adjustment for the difference in disease structure between countries. RESULTS: Average age at @entity204 was 80.9 years. The top 5 comorbid diseases ranked as contributory causes of @entity204 were @entity66 (4.0%), @entity303 (3.8%), @entity6 (3.6%), @entity5 (2.5%), and @entity299 (2.3%). Overall, the @entity204 rates from and with @entity191 were 3.6 and 5.8, respectively. CONCLUSIONS: Analysis restricted to data from the underlying-cause coding system underestimated the national burden of @entity191 comorbidity and mortality. Use of @entity204 certificates and multiple-cause mortality data complement the existing system.
