NCIS News Winter 2019
18 June 2019
Welcome to the winter edition of the National Coronial Information System newsletter. Find out about recent research, database developments, training and upcoming deadlines for access applications.
Psychostimulants linked to 1 in 5 fatal strokes in young adults
A detailed analysis of national coronial records between 2009-2016 found that psychostimulants play a major role in fatal strokes among young adults. Researchers from the National Drug and Alcohol Research Centre (NDARC) at UNSW Sydney found that psychostimulant users made up nearly a fifth of the 279 cases of fatal stroke in adults aged 15-44 years. The majority had evidence of consumption immediately prior to the fatal stroke. The study, published in the Journal of Forensic Sciences, is the first to present national data of psychostimulant use in young adults who experienced a fatal stroke.
Methamphetamine was the most common drug implicated. However, less than half of methamphetamine linked stroke deaths involved high concentrations of the drug, which suggests that even low doses could trigger a deadly stroke. Cases of haemorrhagic stroke were also documented involving other illicit and licit psychostimulants. In no cases were medications for attention deficit hyperactivity disorder identified. None of the young people who died had histories of known stroke risk factors such as obesity, previous strokes, alcohol addictions or diabetes, though they were more likely to smoke.
The study found strokes in psychostimulant users usually occurred deep within the brain. Lead researcher, Professor Shane Darke said “These strokes are far more dangerous and more likely to cause death or disability. Your risk of stroke is substantially increased if you use these drugs, and I don’t think the average user knows about this.” Professor Darke said in many cases, no one recognised the warning signs in the days before the fatal strokes. He said:
“If you are a user and you get a shocking headache or nausea, dizziness, and weakness down one side of your body, seek help immediately”
Shane Darke, Johan Duflou, Sharlene Kaye, Michael Farrell, Julia Lappin. Psychostimulant Use and Fatal Stroke in Young Adults. Journal of Forensic Sciences, 2019.
‘You deserve better’: Warning on aged care facilities
An aged care expert has told the Royal Commission into Aged Care Quality and Safety that unless significant improvements are made, the state of nursing homes in Australia will deteriorate.
Professor Joseph Ibrahim, the Head of the Health Law and Ageing Research Unit at Monash University’s Department of Forensic Medicine, says people living in residential aged care facilities are left “stateless” in a system waiting for them to die, and “no one seems to give a toss”.
Professor Ibrahim presented coronial data on the causes of deaths in nursing homes showing that almost 15% of 22,000 nursing home deaths between 2000 and 2014 were deemed ‘unnatural’, with falls making up the majority. “As most would know deaths reported to the coroner usually have some unusual aspect to them, and we remain curious to this day as to why 18,000 natural cause deaths have been reported,” Professor Ibrahim said.
“I think that residential aged care should have the goal that it’s a place where people can at least enjoy their last few months or years before they die,” he says. “What currently happens is most of us sit around waiting for them to die and if they die quickly then it’s a good job done, everyone sort of thinks it’s a good thing, and it’s clearly not.”
Listen to Prof Joseph Ibrahim speaking about Australia’s aged care system on the MJA podcast.
Seven older people die by suicide in Australia each week
A recently released NCIS fact sheet highlights an average of seven older people die by suicide in Australia each week.
The fact sheet Intentional self-harm deaths of older persons in Australia examines all closed case intentional self-harm deaths of persons aged 65 years or over reported to an Australian coroner between 1 January 2001 and 31 December 2016.
- The highest rate of suicide for older persons for 2016 occurred among those aged 85–89 years (17.4 deaths per 100,000).
- Intentional self-harm deaths occurred most frequently among those who were married or in a de facto relationship (51.8%), followed by those who were widowed (25.3%).
- Older men were at greatest risk, accounting for more than three quarters of intentional self-harm deaths (76%).
Supplementary data coverage
The NCIS integrates supplementary data to enhance the core coronial data set. Supplementary data is batch updated regularly. The table below displays the percentage of cases covered by supplementary data.
|ICD-10 (Australia)||Australian Bureau of Statistics (ABS) assigns International Classification of Diseases (ICD) codes to deaths reported in Australia. Codes are provided to the NCIS in accordance with the Cause of Death, Australia file (cat. 3303.0)||2000– 2017||92%|
|ICD-10-AM (NZ)||New Zealand Ministry of Health (MoH) assigns International Classification of Diseases (ICD-AM) codes to deaths reported in New Zealand||2007– 2016||98%|
|Safe Work Australia||Applies to cases classified by Safe Work Australia as work related. Includes: Worker Type, Occupation, Industry of Employer and the Type of Occurrence Classification System (TOOCS)||2003– 2017||1.2%|
|Geocoding (Australia)||Residential address and incident locations are converted to coordinates and assigned geographic boundaries (excludes New Zealand) according to the ABS Australian Statistical Geography Standard and Local Government Areas||2000-2019||Residential: 93%
NCIS Research Agenda
The NCIS Research Agenda has just been released. The agenda outlines research priorities, activities and outcomes for the 2018-21 calendar years. It focuses on identifying research needs that will enable comprehensive assessment of mortality trends in coronial data by organisations working to reduce preventable death and injury. The agenda has three key focus areas:
- Reporting services: reports provided based on agreements and requests from external parties
- Research publications: publications generated by the NCIS and its data users
- Research tools: tools that provide online open access to specific data
Closing dates for applications
New submission dates for access applications take effect from 1 July 2019.
The next closing date for new and renewing applications is 12 July 2019. Applications received by this date will be considered at the Justice Human Research Ethics Committee (JHREC) meeting on 19 September 2019. Applications for Victorian, Western Australian and Tasmanian data must also be reviewed by these jurisdictions for additional approval.