On this page:
Part 2
Incorrect: |
|
Part 1 |
|
(a) Cardiac Arrest |
1 hour |
(b) Cardiogenic shock |
3 hours |
(c) Lactic acidosis |
3 hours |
Part 2 |
|
Coma (3 hours) |
Insulin-dependent type 2 diabetes mellitus |
Explanation: The problem in the above table is the Type 2 diabetes mellitus was the underlying cause of the lactic acidosis, cardiogenic shock and cardiac arrest so it should be entered in Part 1 (c) as the underlying cause of death. Cardiac arrest was the mode of death so should be omitted.
Correct: |
|
Part 1 |
|
(a) Cardiogenic shock |
1 hour |
(b) Lactic acidosis and coma |
3 hours |
(c) Insulin-dependent type 2 diabetes mellitus |
years |
Part 2 |
|
- |
Mode of dying and Part 2
Example 1:
Incorrect: |
|
Part 1 |
|
(a) Respiratory failure |
7 days |
(b) Left-sided pneumonia |
9 days |
(c) - |
- |
Part 2 |
|
Systemic lupus erythematosus (6 years) |
Immunosuppression, hypertension (years) |
Explanation: The problem in the above table is that systemic lupus erythematosus with immunosuppression was the underlying cause of death so should be entered in Part 1 (c). Respiratory failure was the mode of death so should be omitted
Correct: |
|
Part 1 |
|
(a) Left-sided pneumonia |
9 days |
(b) Immunosuppression due to corticosteroids |
years |
(c) Systemic lupus erythematosus |
6 years |
Part 2 |
|
Hypertension (years) |
Example 2:
Incorrect: |
|
Part 1 |
|
(a) Cardiac Arrest |
minutes |
(b) Cachexia |
2 weeks |
(c) Metastatic poorly differentiated carcinoma |
months |
Part 2 |
|
Malignant ascites (months) |
Ulcerative colitis (42 years) |
Carcinoma cervix (25 years) |
Explanation: The problem here is the primary site of the carcinoma, carcinoma of the cervix, was the underlying cause of the metastatic poorly differentiated carcinoma so should be entered as the underlying cause of death in Part 1. Cardiac arrest was the mode of death so should be omitted.
Correct: |
|
Part 1 |
|
(a) Cachexia |
2 weeks |
(b) Metastatic poorly differentiated carcinoma, malignant ascites |
months |
(c) Carcinoma cervix |
25 years |
Part 2 |
|
Ulcerative colitis (42 years) |
Accidents and injuries in the elderly
Incorrect: |
|
Part 1 |
|
(a) Pneumonia |
2 weeks |
(b) Immobility |
6 weeks |
(c) Fractured neck of left femur |
6 weeks |
Part 2 |
|
Explanation: The problem in the above table is the accident that caused the fractured neck of the femur is the underlying cause of death so needs to be entered below the fractured neck of the femur in Part 1.
Correct: |
|
Part 1 |
|
(a) Pneumonia due to immobility |
6 weeks |
(b) Fractured neck of left femur |
6 weeks |
(c) Slipped and fell on bathroom floor at home |
6 weeks |
Part 2 |
|
Atherosclerosis – specificity
Incorrect: |
|
Part 1 |
|
(a) Congestive heart failure |
4 days |
(b) Atherosclerosis |
20 years |
(c) |
|
Part 2 |
|
Cerebrovascular accident (2 years) |
Explanation: The problem here is atherosclerosis can affect different organs in the body so more information needs to be entered in Part 1 to indicate the organ affected. This allows more specific classification of the underlying cause of death
Correct: |
|
Part 1 |
|
(a) Congestive cardiac failure |
4 days |
(b) Ischaemic heart disease |
20 years |
(c) Atherosclerosis |
20+ years |
Part 2 |
|
Cerebrovascular accident (2 years) |
Cancer – exact site of primary cancer
Incorrect: |
|
Part 1 |
|
(a) Septicaemia |
7 days |
(b) Disseminated malignancy |
2 years |
(c) Bowel cancer |
4 years |
Part 2 |
|
Explanation: The problem here is that ‘Bowel cancer’ is not specific enough (unless the exact primary site within the bowel is unknown). Specify the site within the bowel.
Correct: |
|
Part 1 |
|
(a) Septicaemia |
7 days |
(b) Disseminated malignancy |
2 years |
(c) Cancer of sigmoid colon |
4 years |
Part 2 |
|
Metastases – site of primary cancer
Incorrect: |
|
Part 1 |
|
(a) Metastatic adenocarcinoma of bones |
3 months |
(b) |
|
(c) |
|
Part 2 |
|
Aspiration pneumonia |
7 days |
Explanation: The problem here is the primary site of the cancer is not stated. Aspiration pneumonia is the direct cause of death so should be entered in Part 1 (a).
Correct: |
|
Part 1 |
|
(a) Aspiration pneumonia |
7 days |
(b) Metastatic adenocarcinoma of bones |
3 months |
(c) Adenocarcinoma prostate |
2 years |
Part 2 |
|
Qualify 'neoplasm or tumour'
Incorrect: |
|
Part 1 |
|
(a) Cerebral neoplasm |
several months |
(b) |
|
(c) |
|
Part 2 |
|
Explanation: The problem here is the type of cerebral neoplasm is unstated. The person classifying the cause of death cannot tell if the cerebral neoplasm was malignant or benign, and if it was malignant, whether it was a primary or secondary cancer.
Correct: |
|
Part 1 |
|
(a) Astrocytoma cerebellum |
several months |
(b) |
|
(c) |
|
Part 2 |
|
Note: Astrocytoma is considered to be a primary cancer of the brain, (unless specified otherwise), therefore entering Astrocytoma cerebellum in Part 1 (a) provides all the information that is required to accurately describe the underlying cause of death.
Cardiac arrhythmias
Incorrect : |
|
Part 1 |
|
(a) Chronic heart failure |
- |
(b) |
|
(c) |
|
Part 2 |
|
Atrial fibrillation |
Explanation: The problem here is that cardiac arrhythmias are often caused by other known heart disease. Where this is the case the underlying heart disease should be entered as the cause of the arrhythmia.
Correct: |
|
Part 1 |
|
(a) Chronic heart failure |
months |
(b) Atrial fibrillation |
1 year |
(c) Coronary atherosclerosis |
years |
Part 2 |
|
Gastrointestinal haemorrhage
Incorrect: |
|
Part 1 |
|
(a) Gastrointestinal haemorrhage |
2 weeks |
(b) |
|
(c) |
|
Part 2 |
|
Explanation: The problem here is the cause of the gastrointestinal haemorrhage (the direct cause of death) is not stated.
Correct: |
|
Part 1 |
|
(a) Gastrointestinal haemorrhage |
2 weeks |
(b) Prolonged use non-steroidal anti-inflammatory drugs |
16 years |
(c) Rheumatoid arthritis multiple sites |
16 years |
Part 2 |
|
Operation
Incorrect: |
|
Part 1 |
|
(a) Bronchopneumonia |
2 days |
(b) Post-op hernia repair |
4 days |
(c) |
|
Part 2 |
|
Explanation: The problem here is that, whilst it is important to know the deceased had surgery in the days or month prior to death, the condition for which the surgery was required is classified as the underlying cause of death. Therefore details about that condition need to be included in Part 1 (c).
Correct: |
|
Part 1 |
|
(a) Bronchopneumonia |
2 days |
(b) Post-op hernia repair |
4 days |
(c) Strangulated left inguinal hernia |
5 days |
Part 2 |
|
Pneumonia
Incorrect: |
|
Part 1 |
|
(a) Pneumonia |
2 weeks |
(b) Immobilisation |
12 months |
(c) |
|
Part 2 |
|
Explanation: The problem here is the condition causing immobilisation has not been documented. That condition will be the underlying cause of death.
Correct: |
|
Part 1 |
|
(a) Pneumonia |
2 weeks |
(b) Immobilisation |
12 months |
(c) Multiple Sclerosis |
25 years |
Part 2 |
|
Pulmonary embolism
Incorrect: |
|
Part 1 |
|
(a) Pulmonary embolus |
immediate |
(b) Immobility |
6 months |
(c) |
|
Part 2 |
|
Chronic bronchitis and emphysema (6 years) |
|
Explanation: The problem here is that pulmonary embolism often results from a deep vein thrombosis that has developed due to immobility caused by another condition. The condition resulting in immobility should be entered as the underlying cause of death.
Correct: |
|
Part 1 |
|
(a) Pulmonary embolus |
immediate |
(b) Deep vein thrombosis due to immobility |
3 days |
(c) Chronic bronchitis and emphysema |
6 years |
Part 2 |
|