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Causes Of Death And Death Certificates
Death Certificate data constitute an
available, comprehensive, relatively uniform and generally
reliable source of information to describe mortality trends in
the population. Central to the process of calculating mortality
rates and determining leading causes of death is the correct
coding of the underlying cause of death. The underlying cause of
death, which is the last listed cause in Box 107 of the Death
Certificate, is defined as the disease, abnormality, or injury
that led to death. It must have an etiologic or pathologic
relationship to the intervening and immediate causes of death
listed above it, and it must have initiated the lethal chain of
events, no matter how long the time interval.
Beginning on January 1, 2000, the County of
Orange Health Care Agency, Birth and Death Registration Unit
began coding the underlying cause of death on Death Certificates
using the International Statistical Classification of Diseases
and Related Health Problems, Tenth Revision (ICD-10). The Tenth
Revision differs from the Ninth Revision (ICD-9) in a number of
respects although the overall content is similar. Changes have
been made in the coding rules for mortality to improve the
usefulness of the mortality statistics by giving preference to
certain categories and by systematically selecting a single
cause of death from a reported sequence of conditions. In order
for the coding rules to be applied appropriately, the physician
certifying the death and its causes must complete the
appropriate sections of the Death Certificate correctly.
To better aid the physician in completing the
causes/conditions of death sections on a Death Certificate, the
following rules are provided (refer to graphic below):
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Up to 4 causes of death can be listed in
Box 107 (only 1 cause can be entered on each line). Causes
listed in lines A, B, C, and D in Box 107 should be in
chronological and pathological order such that the most
immediate cause of death is listed in A, any cause listed in
B led to the cause in A and preceded it, any cause listed in
C led to B and preceded it, and any cause listed in D led to
the cause in C and preceded it.
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Time intervals listed in lines A, B, C,
and D in Box 107 must be in chronological order with the
most recent event or condition first.
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Box 112 should be reserved for conditions
contributing to death but not an underlying cause or one of
the causes in the chain of events that led to death.
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If an operation is specified in Box 107 or
Box 112, then it must also be listed in Box 113.
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If a biopsy is specified in Box 107 or Box
112, then "Yes" must also be checked in Box 109.
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If no autopsy was performed ("No" checked
in Box 110), then either "No" should be checked in Box 111
or Box 111 should be left blank.
A Death Certificate completed in
accordance with the rules above will reduce the amount of time
spent by the physician, mortuary and registration staff in
correcting errors. Additionally, a correct certificate will
eliminate the need to file an amendment to the Death Certificate
at a later date. Should you have further questions regarding the
Death Certificate registration process, please telephone the
Birth and Death Registration Unit at (714) 480-6700.
For additional information on writing
cause-of-death statements, click on the link below to be routed
to the
National Center for Health Statistics, National Vital Statistics
System web site. |
