Public Health Agency of Canada
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Injury Surveillance On-Line

Health Surveillance and Epidemiology Division, Centre for Health Promotion

Glossary

Adverse events:
A group of conditions included in the ICD-9 chapter on External Causes of Injury and Poisoning.

ICD-9 codes

Description

E870-E876

Misadventures to patients during medical and surgical care.

E878-E879

Surgical and medical procedures as the cause of abnormal reaction of patient or later complication, without mention of misadventure at time of procedure.

E930-E949

Drugs, medicinal and biological substances causing adverse effects in therapeutic use.

These conditions differ from most injuries, both in their nature and in the types of measures that might be considered appropriate to prevent them. They are excluded from the counts of injuries on this web site.

Age-standardized rates:
See standardized rates.
Age- and sex-standardized rates.:
See standardized rates.
Age-specific rate:
The number of cases per 100,000 persons per year for a specific, narrow age range. Five-year age groups are commonly used.
Assault:
The infliction of non-fatal injury by another person, by any means, with intent to injure or kill. Injuries resulting from legal intervention and operations of war are excluded. See Homicide.
Canadian Institute for Health Information (CIHI):
The Institute provides the hospital separation data used in Injury Surveillance on Line as well as much other health-related data. An important injury-related activity of CIHI is management of the National Trauma Registry. It includes a Minimal Data Set (information on all hospitalizations due to trauma in acute care hospitals in Canada) and a Comprehensive Data Set (detailed information on patients hospitalized with major injury in selected hospitals and major trauma centres). See http://www.cihi.ca.
CHIRPP (the Canadian Hospitals Injury Reporting and Prevention Program):
An emergency department-based injury surveillance program operated by Health Canada in collaboration with 10 children's and 5 general hospitals.
CIHI:
See Canadian Institute for Health Information.
Crude Rate:
The number of new cases or deaths per 100,000 persons per year. Age and sex distributions are not taken into consideration in the calculation.
E-Codes:
ICD-9 codes used to describe the external causes of injuries and poisonings.
External causes:
Term used in ICD to describe environmental events, circumstances, and conditions identified as the causes of injuries, poisonings and other adverse events. External causes are listed in ICD-9 in the Supplementary classification of external causes of injury and poisoning (E-codes). In ICD-10 the external causes are presented in Chapter XIX (V- to Y- codes).
Homicide:
Death due to injury inflicted, by any means, by another person with intent to injure or kill. Death resulting from legal intervention and operations of war are excluded. See Assault
Hospital separations:
The number of in-patients who leave hospital through discharge or death. Separation rates are often used to study morbidity trends. The separation data presented on Injury Surveillance On Line are provided by CIHI and analyzed by Health Canada.
It should be noted that an individual can be admitted to hospital more than once for the treatment of the same injury and that injury separation data are simply the numbers of discharges or deaths following admission for treatment of injury. They do not represent either the number of injuries that led to the separations or the number of injured people who separated from the hospital.
Also, since a small proportion of the records sent to CIHI are not subject to verification for inclusion of an E-code, the separation data provided by Injury Surveillance on Line should be considered a minimum estimate of the number of hospitalizations for treatment of injuries.
ICD-9:
The International Classification of Diseases, ninth revision. The World Health Organization standard classification of diseases; used for Canadian mortality data from 1979 to 2000 and for Canadian hospital separation data from 1979 to between 2002 and 2004.
ICD-10:
The International Classification of Diseases, tenth revision. The World Health Organization standard classification of diseases which came into use in 1994; used for Canadian mortality data beginning in 2000. Classification of hospital separation data using ICD-10-CA has been implemented gradually beginning in fiscal year 2001-02.
ICD-10-CA:
A Canadian modification of the ICD-10 classification used only for hospital separation data, has been implemented gradually beginning in fiscal year 2001-02. See note on implementation of ICD-10.
See this link for more information:
http://secure.cihi.ca/cihiweb/en/downloads/codingclass_icd10enhan_e.pdf
Incidence:
The number of new cases of injury or disease during a period of time.
Injury:
A bodily lesion resulting from acute overexposure to energy (this can be mechanical, thermal, electrical, chemical or radiant) interacting with the body in amounts or rates that exceed the threshold of physiological tolerance. In some cases an injury results from an insufficiency of any of the vital elements (e.g. oxygen, warmth). Acute poisonings and toxic effects, including overdoses of substances and wrong substances given or taken in error are included, as are adverse effects and complications of therapeutic, surgical and medical care. Psychological harm is excluded.
Note: the scope of this definition is in accordance with the scope of the ICD-9 supplementary classification of external causes of injury and poisoning and ICD-10 chapter XIX
Injury event:
An incident that results in injury.
Intent (of injury):
The role of human purpose in an injury event
Intentionally self-inflicted injury:
Injury purposefully caused by the victim to him/herself.
Legal intervention, injuries due to :
Injuries inflicted by the police or other law-enforcing agents, including military on duty, in the course of arresting or attempting to arrest lawbreakers, suppressing disturbances, maintaining order, and other legal action. Includes legal execution. Excludes injuries caused by civil insurrections, which are classified as injuries due to operations of war.
Location of occurrence:
Where the injury happened.
Mechanism of injury:
The way in which the injury was sustained; how the person was hurt.
Morbidity:
Illness caused by a particular injury or disease. The only measures of injury morbidity presented in Injury Surveillance on Line are numbers and rates of hospital separations associated with injuries or illnesses.
Mortality:
Death caused by a particular injury or disease.
Operations of war, injuries due to:
Injuries to military personnel and civilians caused by war and civil insurrections and occurring during the time of war and insurrection.
Other Unintentional:
This group comprises all unintentional injury less motor vehicle traffic collisions and falls (excluding fracture cause unspecified).
Public health surveillance:
The ongoing systematic collection, analysis, interpretation, and dissemination of risk factor, exposure, and/or outcome-specific data for use in public health practice.
Rate:
The proportion of a group affected over a period of time, such as a year. It is usually expressed as new cases (or deaths, separations, etc.) per 100,000 people per year.
Risk factor:
A risk factor is a factor associated with an increase in the chances of being injured or being affected with a disease; it may be a cause or simply a risk marker. Factors associated with decreased risk are known as protective factors.
Self-inflicted injury:
Injury caused by action of the injured person against him/herself
Standardized rates:
Summary adjusted rates that represent what the crude rates in the populations studied would be if their age (and sex) distributions were the same as that of a selected standard population. Standardized rates are useful for comparing the rates of injury or disease in populations that may have different age (and sex) distributions (such as the populations of different jurisdictions, or of the same jurisdiction in different years). However, it is important to be aware that the summary measures produced by standardization may mask important differences in the age (and sex) specific rates of the populations being compared. For comparisons to be meaningful, the same standard population must be used in the calculation of all standardized rates being compared. Direct standardization is used. Age standardized rates are based on the age-specific rates in the population studied and the age distribution of the standard population. They are only calculated for a single sex.
Age and sex standardized rates are based on the age- and sex-specific rates in the population studied and the age and sex distributions of the standard population. They are only calculated for both sexes combined.
Standard population:
A specific population whose age (and sex) distribution) is used in the calculation of standardized rates. The standard population used in Injury Surveillance on Line is the 1991 Canadian population.
Suicide:
Intentionally self-inflicted injury that results in death.
Surveillance:
Injury surveillance includes the collection of data, and the review, analysis and dissemination of findings on incidence (new cases), prevalence, morbidity, survival and mortality. Surveillance also serves to collect information on the knowledge, attitudes and behaviours of the public with respect to practices that prevent injuries, facilitate screening, extend survival and improve quality of life.
Undetermined intent:
Classification used when after a thorough investigation it cannot be determined whether the injuries are unintentional, due to suicide (intentionally self-inflicted) or due to homicide (assault). It includes self-inflicted injuries, other than poisonings, when not specified as accidental or intentional. For poisoning: When ICD-9 was used for mortality coding self-inflicted poisoning, unspecified whether unintentional or with intent to harm, was classified as unintentional.
Unintentional injury:
Injury that is not purposely inflicted, either by the patient or anyone else. In the past, unintentional injuries were referred to as accidental injuries.

Special Notes

Standardization:
Age standardized rates are used for charts and tables that compare data for a single sex from different years and/or different places.
In charts and tables that compare data on both sexes combined from different years and/or different places the rates are standardized for both age and sex.
Year vs. fiscal year:
Mortality data are presented for calendar years (e.g. January 1st - December 31st, 2001).
Hospital separation data are presented for fiscal years (e.g. April 1st, 2001 - March 31st, 2002).
Falls:
There is an important difference in the classification of falls between ICD-9 and ICD-10. In ICD-9 the Falls section includes cases where the external cause of injury is specified as "Fracture, cause unspecified (E887)." These cases, which account for a large proportion of fatal falls among the elderly, are not classified as Falls in ICD-10, or in the U.S. Recommended framework for presenting injury mortality data. (Refs: MMWR 1997;46(No. RR-14):1-30 or www.cdc.gov/mmwr/pdf/rr/rr4614.pdf. To allow users to select the group of falls that best suits their purposes, it is possible to choose either "Falls, including fracture cause unspecified" or "Falls, excluding fracture cause unspecified ."
It should also be noted that, particularly for the mortality data, changes in the classification of falls introduced with ICD-9 in 1979 were not consistently applied immediately. During the early 1980s increasing proportions of events were classified to E887 (Fracture, cause unspecified) and there were corresponding decreases in the numbers of events classified to E880-E886 and E888 (Other unintentional falls).
Availability of provincial hospital separation data:
External cause data for hospital separations was not available for all provinces and territories until 1994-95. Therefore "Canada" is only a valid event area selection for hospital separations from 1994-95 on.
      • Prince Edward Island data are available from 1986-87 on, with the exception of 1990-91.
      • New Brunswick data are available as a three digit ICD-9 code from 1981-82 to1987-88 and as the full ICD-9 code from 1994-95 on.
      • British Columbia used the abbreviated ICD-9 code for 1981-82 and 1982-83.
      • Data from the territories are available from 1994-95 on.
      • Data from other provinces are available from 1981-1982 on.
Hospitalization Data:
Pregnancy related hospitalizations have been removed from "Females" and "Males and Females Combined" data in order to permit a more accurate comparison.