Cause of death

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In law, medicine, and statistics, cause of death is an official determination of the conditions resulting in a human's death, which may be recorded on a death certificate. A cause of death is determined by a medical examiner. In rare cases, an autopsy needs to be performed by a pathologist. The cause of death is a specific disease or injury, in contrast to the manner of death, which is a small number of categories like "natural", "accident", "suicide", and "homicide", each with different legal implications. [1]

Contents

International Classification of Disease (ICD) codes can be used to record manner and cause of death in a systematic way that makes it easy to compile statistics and more feasible to compare events across jurisdictions. [2]

Accuracy concerns

A study published in Preventing Chronic Disease found that only one-third of New York City resident physicians reported believing that the present system of documentation was accurate. Half reported the inability to record "what they felt to be the correct cause of death", citing reasons such as technical limitation and instruction to "put something else". Nearly four-fifths reported being unaware that determinations of "probable", "presumed", or "undetermined" could be made, and fewer than three percent reported ever updating a death certificate when conflicting lab results or other new information became available, and cardiovascular disease was indicated as "the most frequent diagnosis inaccurately reported". [3]

Causes of death are sometimes disputed by relatives or members of the public, particularly when some degree of uncertainty or ambiguity exists in relation to the cause of death. On occasion, such disputes may result from, or sometimes instigate, a conspiracy theory.

Public perception of the relative risk of death by various causes is biased by personal experience and by media coverage. The phrase "hierarchy of death" is sometimes used to describe the factors that cause some deaths to get more attention than others.

Though some opponents of abortion consider it a cause of death, conventionally medical authorities do not confer personhood on fetuses that are not viable outside the womb, and thus abortions are not reported as deaths in these statistics. [4]

Aging

Health departments discourage listing "old age" as the cause of death because doing so does not benefit public health or medical research. [5] Aging is not a scientifically recognized cause of death; it is currently considered that there is always a more direct cause (although it may be unknown in certain cases and could be one of a number of aging-associated diseases). As an indirect or non-determinative factor, biological aging is the biggest contributor to deaths worldwide. It is estimated that of the roughly 150,000 people who die each day across the globe, about two thirds—100,000 per day—die of age-related causes. [6] In industrialized nations the proportion is much higher, reaching 90%. [6] In recent years, there have been official claims about a possibility of recognizing aging itself as a disease. [7] [8] [9] [10] [11] If this would be so, the situation would change.

Emotional death

There are also popular notions that someone can be "scared to death" or die of loneliness or heartbreak. Experiencing fear, extreme stress, or both can cause changes in the body that can, in turn, lead to death. For example, it is possible that overstimulation of the vagus nerve—which decreases heart rate in a mechanism related to the behavior of apparent death (also known as "playing dead" and "playing possum")—is the cause of documented cases of psychogenic death. The flight or fight response to fear or stress has the opposite effect, increasing heart rate through stress hormones, and can cause cardiovascular problems (especially in those with pre-existing conditions). This is the proposed mechanism for the observed increase in the death rate due to cardiac arrest after widely experienced acutely stressful events such as terrorism, military attacks, and natural disasters (even among those who are not in the affected area) and for documented deaths in muggings and other frightening events which caused no traumatic physical harm. [12] [13] The proximal medical cause of death in these cases is likely to be recorded as cardiac failure or vagal inhibition (which also has other potential causes such as blows to certain parts of the body and nerve injuries). [14]

One specific condition observed to result from acute stress, takotsubo cardiomyopathy, is nicknamed "broken heart syndrome", but the stress need not be relationship-related and need not be negative. [15]

See also

Related Research Articles

<span class="mw-page-title-main">Vagus nerve</span> Cranial nerve X, for visceral innervation

The vagus nerve, also known as the tenth cranial nerve, cranial nerve X, or simply CN X, is a cranial nerve that carries sensory fibers that create a pathway that interfaces with the parasympathetic control of the heart, lungs, and digestive tract. It comprises two nerves—the left and right vagus nerves—but they are typically referred to collectively as a single subsystem. The vagus is the longest nerve of the autonomic nervous system in the human body and comprises both sensory and motor fibers. The sensory fibers originate from neurons of the nodose ganglion, whereas the motor fibers come from neurons of the dorsal motor nucleus of the vagus and the nucleus ambiguus. The vagus was also historically called the pneumogastric nerve.

<span class="mw-page-title-main">Cardiomyopathy</span> Disease of the heart muscle

Cardiomyopathy is a group of diseases that affect the heart muscle. Early on there may be few or no symptoms. As the disease worsens, shortness of breath, feeling tired, and swelling of the legs may occur, due to the onset of heart failure. An irregular heart beat and fainting may occur. Those affected are at an increased risk of sudden cardiac death.

<span class="mw-page-title-main">Cardiac arrest</span> Sudden stop in effective blood flow due to the failure of the heart to beat

Cardiac arrest is when the heart stops beating. It is defined as cessation of normal circulation of blood due to failure of the heart to pump effectively. It is a medical emergency that, without immediate medical intervention, will result in cardiac death within minutes. When it happens suddenly, it is called sudden cardiac arrest. Cardiopulmonary resuscitation (CPR) and possibly defibrillation are needed until further treatment can be provided. Cardiac arrest results in a rapid loss of consciousness, and breathing may be abnormal or absent.

<span class="mw-page-title-main">Senescence</span> Deterioration of function with age

Senescence or biological aging is the gradual deterioration of functional characteristics in living organisms. The word senescence can refer to either cellular senescence or to senescence of the whole organism. Organismal senescence involves an increase in death rates and/or a decrease in fecundity with increasing age, at least in the latter part of an organism's life cycle.

Heart rate is the frequency of the heartbeat measured by the number of contractions of the heart per minute. The heart rate can vary according to the body's physical needs, including the need to absorb oxygen and excrete carbon dioxide, but is also modulated by numerous factors, including genetics, physical fitness, stress or psychological status, diet, drugs, hormonal status, environment, and disease/illness as well as the interaction between and among these factors. It is usually equal or close to the pulse measured at any peripheral point.

<span class="mw-page-title-main">Maternal death</span> Aspect of human reproduction and medicine

Maternal death or maternal mortality is defined in slightly different ways by several different health organizations. The World Health Organization (WHO) defines maternal death as the death of a pregnant mother due to complications related to pregnancy, underlying conditions worsened by the pregnancy or management of these conditions. This can occur either while they are pregnant or within six weeks of resolution of the pregnancy. The CDC definition of pregnancy-related deaths extends the period of consideration to include one year from the resolution of the pregnancy. Pregnancy associated death, as defined by the American College of Obstetricians and Gynecologists (ACOG), are all deaths occurring within one year of a pregnancy resolution. Identification of pregnancy associated deaths is important for deciding whether or not the pregnancy was a direct or indirect contributing cause of the death.

<span class="mw-page-title-main">Diseases of affluence</span> Health conditions thought to be a result of increasing wealth in society

Diseases of affluence, previously called diseases of rich people, is a term sometimes given to selected diseases and other health conditions which are commonly thought to be a result of increasing wealth in a society. Also referred to as the "Western disease" paradigm, these diseases are in contrast to so-called "diseases of poverty", which largely result from and contribute to human impoverishment. These diseases of affluence have vastly increased in prevalence since the end of World War II.

<span class="mw-page-title-main">Cardiomegaly</span> Medical condition

Cardiomegaly is a medical condition in which the heart becomes enlarged. It is more commonly referred to simply as "having an enlarged heart". It is usually the result of underlying conditions that make the heart work harder, such as obesity, heart valve disease, high blood pressure (hypertension), and coronary artery disease. Cardiomyopathy is also associated with cardiomegaly.

A chronic condition is a health condition or disease that is persistent or otherwise long-lasting in its effects or a disease that comes with time. The term "chronic" is often applied when the course of the disease lasts for more than three months. Common chronic diseases include diabetes, functional gastrointestinal disorder, eczema, arthritis, asthma, chronic obstructive pulmonary disease, autoimmune diseases, genetic disorders and some viral diseases such as hepatitis C and acquired immunodeficiency syndrome. An illness which is lifelong because it ends in death is a terminal illness. It is possible and not unexpected for an illness to change in definition from terminal to chronic. Diabetes and HIV for example were once terminal yet are now considered chronic due to the availability of insulin for diabetics and daily drug treatment for individuals with HIV which allow these individuals to live while managing symptoms.

<span class="mw-page-title-main">Muscle atrophy</span> Medical condition

Muscle atrophy is the loss of skeletal muscle mass. It can be caused by immobility, aging, malnutrition, medications, or a wide range of injuries or diseases that impact the musculoskeletal or nervous system. Muscle atrophy leads to muscle weakness and causes disability.

Vagal tone is activity of the vagus nerve, the 10th cranial nerve and a fundamental component of the parasympathetic branch of the autonomic nervous system. This branch of the nervous system is not under conscious control and is largely responsible for the regulation of several body compartments at rest. Vagal activity results in various effects, including: heart rate reduction, vasodilation/constriction of vessels, glandular activity in the heart, lungs, and digestive tract, liver, immune system regulation as well as control of gastrointestinal sensitivity, motility and inflammation.

<span class="mw-page-title-main">Aging-associated diseases</span> Type of disease

An aging-associated disease is a disease that is most often seen with increasing frequency with increasing senescence. They are essentially complications of senescence, distinguished from the aging process itself because all adult animals age but not all adult animals experience all age-associated diseases. The term does not refer to age-specific diseases, such as the childhood diseases chicken pox and measles, only diseases of the elderly. They are also not accelerated aging diseases, all of which are genetic disorders.

In medicine, an external cause is a reason for the existence of a medical condition which can be associated with a specific object or acute process that was caused by something outside the body. Such causes are classified as "E codes" in ICD 9.

<span class="mw-page-title-main">Ageing</span> Biological process of getting older

Ageing is the process of becoming older. The term refers mainly to humans, many other animals, and fungi, whereas for example, bacteria, perennial plants and some simple animals are potentially biologically immortal. In a broader sense, ageing can refer to single cells within an organism which has ceased dividing, or to the population of a species.

<span class="mw-page-title-main">Coronary ischemia</span> Medical condition

Coronary ischemia, myocardial ischemia, or cardiac ischemia, is a medical term for a reduced blood flow in the coronary circulation through the coronary arteries. Coronary ischemia is linked to heart disease, and heart attacks. Coronary arteries deliver oxygen-rich blood to the heart muscle. Reduced blood flow to the heart associated with coronary ischemia can result in inadequate oxygen supply to the heart muscle. When oxygen supply to the heart is unable to keep up with oxygen demand from the muscle, the result is the characteristic symptoms of coronary ischemia, the most common of which is chest pain. Chest pain due to coronary ischemia commonly radiates to the arm or neck. Certain individuals such as women, diabetics, and the elderly may present with more varied symptoms. If blood flow through the coronary arteries is stopped completely, cardiac muscle cells may die, known as a myocardial infarction, or heart attack.

<span class="mw-page-title-main">Myocardial infarction</span> Interruption of blood supply to a part of the heart

A myocardial infarction (MI), commonly known as a heart attack, occurs when blood flow decreases or stops in the coronary artery of the heart, causing damage to the heart muscle. The most common symptom is chest pain or discomfort which may travel into the shoulder, arm, back, neck or jaw. Often it occurs in the center or left side of the chest and lasts for more than a few minutes. The discomfort may occasionally feel like heartburn. Other symptoms may include shortness of breath, nausea, feeling faint, a cold sweat or feeling tired. About 30% of people have atypical symptoms. Women more often present without chest pain and instead have neck pain, arm pain or feel tired. Among those over 75 years old, about 5% have had an MI with little or no history of symptoms. An MI may cause heart failure, an irregular heartbeat, cardiogenic shock or cardiac arrest.

<span class="mw-page-title-main">Arrhythmia</span> Group of medical conditions characterized by irregular heartbeat

Arrhythmias, also known as cardiac arrhythmias, heart arrhythmias, or dysrhythmias, are irregularities in the heartbeat, including when it is too fast or too slow. A resting heart rate that is too fast – above 100 beats per minute in adults – is called tachycardia, and a resting heart rate that is too slow – below 60 beats per minute – is called bradycardia. Some types of arrhythmias have no symptoms. Symptoms, when present, may include palpitations or feeling a pause between heartbeats. In more serious cases, there may be lightheadedness, passing out, shortness of breath or chest pain. While most cases of arrhythmia are not serious, some predispose a person to complications such as stroke or heart failure. Others may result in sudden death.

In many legal jurisdictions, the manner of death is a determination, typically made by the coroner, medical examiner, police, or similar officials, and recorded as a vital statistic. Within the United States and the United Kingdom, a distinction is made between the cause of death, which is a specific disease or injury, versus manner of death, which is primarily a legal determination versus the mechanism of death which does not explain why the person died or the underlying cause of death and can include cardiac arrest or exsanguination. Different categories are used in different jurisdictions, but manner of death determinations include everything from very broad categories like "natural" and "homicide" to specific manners like "traffic accident" or "gunshot wound". In some cases an autopsy is performed, either due to general legal requirements, because the medical cause of death is uncertain, upon the request of family members or guardians, or because the circumstances of death were suspicious.

Occupational cardiovascular diseases (CVD) are diseases of the heart or blood vessels caused by working conditions, making them a form of occupational illness. These diseases include coronary heart disease, stroke, cardiomyopathy, arrythmia, and heart valve or heart chamber problems. Cardiovascular disease is the leading cause of death in the United States and worldwide. In the United States, cardiovascular diseases account for one out of four deaths. The 6th International Conference on Work Environment and Cardiovascular Diseases found that within the working age population about 10-20% of cardiovascular disease deaths can be attributed to work. Ten workplace stressors and risk factors were estimated to be associated with 120,000 U.S. deaths each year and account for 5-8% of health care costs.

References

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