Associations between chronic diseases and choking deaths among older adults in the USA: A cross-sectional study using multiple cause mortality data from 2009 to 2013

Objectives: To examine whether the strengths of the associations between chronic diseases and overall choking differ from those of the associations between chronic diseases and only food-related choking. Design: This cross-sectional study used nationwide multiple cause mortality files. Setting: The USA. Participants: Older adults aged 65 years or more died between 2009 and 2013. Main outcome measures: Mortality ratio (observed/expected) of number of deaths from both causes (chronic diseases and choking) and 95% CIs. Results: We identified 76543 deaths for which the death certificates report choking (International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) codes W78, W79 and W80 combined) as a cause of death and only 4974 (6.5%) deaths were classified as food-related choking (ICD-10 code W79). Schizophrenia, Parkinson's disease, Alzheimer's disease and oral cancer are four chronic diseases that had significant associations with both overall and food-related choking. Stroke, larynx cancer and mood (affective) disorders had significant associations with overall choking, but not with food-related choking. Conclusions: We suggest using overall choking instead of only food-related choking to better describe the associations between chronic diseases and choking.