Quantifying multiple causes of death: Observed patterns in Australia, 2006-2017
Date
2021
Authors
Bishop, Karen
Balogun, Saliu
Eynstone-Hinkins, James
Moran, Lauren
Moreno-Betancur, Margarita
Korda, Rosemary
Rao, Chalapati
Banks, Emily
Joshy, Grace
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Volume Title
Publisher
Oxford Academic
Abstract
Background
Four fifths of deaths in Australia involve multiple causes, but statistics typically use a single underlying cause of death (UC). The UC approach alone is insufficient for understanding the impact of non-underlying causes and identifying comorbid disease associations at death. Analysis of multiple causes of death (MC) is needed to measure the impact of all causes. We described MC patterns, considering cause-of-death coding and certification practices in Australia.
Methods
Using deaths registered in Australia from 2006 to 2017 (n = 1773525) coded to the International Classification of Diseases (ICD) and an extended classification (n = 136 causes) based on a World Health Organization short list, we described MCoD data by cause. Age-standardised rates based on UC and MC were compared using the standardised ratio of multiple to underlying causes (SRMU) to estimate the contribution of the cause to mortality compared to using the UC approach. Comorbidity was explored using the cause of death association indicator (CDAI) to compare the observed joint frequency of a contributory-underlying cause combined with expected frequency of the contributory cause (with any UC).
Results
On average 3.4 conditions caused each death and 24.4% of deaths had 5 plus causes. Largest SRMUs were for genitourinary diseases (8.0), blood diseases (7.8) and musculoskeletal conditions (6.7). CDAIs showed high associations between, for example, accidental alcohol and opioid poisoning, septicaemia and skin infections, and traumatic brain injury and falls.
Conclusions
MC indicators enhance measures of mortality and reassess the role of causes of death for descriptive and analytical epidemiology.
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Type
Conference paper
Book Title
International Journal of Epidemiology Volume 50, Issue Supplement_1 September 2021
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2099-12-31
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