MULTIPLE CAUSES OF DEATH - IN DETAIL

Number of Multiple Causes

For the 153,580 deaths registered in Australia in 2014, there were 512,096 causes mentioned, giving a mean of 3.3 causes per death. In 17.6% of all deaths, only one cause was reported, while 61.3% of deaths were reported with three or more causes. The mean number of causes reported per death varies with age, sex and underlying cause of death.


Selected Multiple Causes

In 2014, Malignant cancers (C00-C97, D45) contributed to 32.7% (50,232) of all deaths as either an underlying or multiple cause. There were mentions of 63,900 malignant cancers reported in 2014.

Ischaemic heart diseases (I20-I25) which includes angina, heart attacks, and blocked arteries of the heart, were found to contribute to 23.5% (36,158) of all deaths as either an underlying or multiple cause.

The following table lists counts of selected causes of death (as opposed to mentions), both underlying and multiple causes, appearing on death certificates for deaths in the 2014 reference year.

6.1 SELECTED MULTIPLE CAUSES OF DEATH: 2014(a)(b)(c)
	UNDERLYING CAUSE		MULTIPLE CAUSE
	Underlying	Proportion of total deaths	Multiple	Proportion of total deaths	Mean no. of causes
Cause of death and ICD code	no.	%	no.	%	no.
All Causes	153 580	100.0	153 580	100.0	3.3
Malignant cancers (C00-C97, D45)	43 572	28.4	50 232	32.7	2.6
Ischaemic heart diseases (I20-I25)	20 173	13.1	36 158	23.5	3.7
Dementia including Alzhiemer's disease (F01, F03, G30)	11,965	7.8	23 970	15.6	3.1
Cerebrovascular diseases (I60-I69)	10,765	7.0	20 169	13.1	3.2
Chronic lower respiratory diseases (J40-J47)	7 810	5.1	17 317	11.3	3.9
Diabetes (E10-E14)	4 348	2.8	15 740	10.2	5.1
Heart failure (I50, I51)	3 447	2.2	22 491	14.6	2.9
Diseases of the kidney and urinary system (N00-N39)	3 136	2.0	22 218	14.5	3.4
Influenza and pneumonia (J09-J18)	2 873	1.9	17 416	11.3	2.6
Intentional self-harm (X60-X84, Y87.0)(d)	2 864	1.9	2 867	1.9	4.0
Hypertensive diseases (I10-I15)	2 225	1.4	20 017	13.0	4.6
Land transport accidents (V01-V89, Y85.0)	1 332	0.9	1 385	0.9	3.2
(a) Causes of death data for 2014 are preliminary and subject to a revisions process. See Explanatory Notes 52-54 and theCauses of Death Revisions, 2012 and 2013 Technical Note in this publication.
(b) Data cells with small values have been randomly assigned to protect the confidentiality of individuals. As a result, some totals will not equal the sum of their components. Cells with a zero value have not been affected by confidentialisation.
(c) See Explanatory Notes 68-94 for further information on specific issues relating to 2014 and time-series data.
(d) Includes ICD-10 codes X60-X84 and Y87.0. Care needs to be taken in interpreting figures relating to suicide. See Explanatory Notes 85-92.

Relationships between Multiple Causes

Influenza and pneumonia (J09-J18) was identified as the underlying cause for 2,873 deaths in 2014. In 27.5% of cases, Influenza and pneumonia was reported alone. In contrast, Diabetes (E10-E14) was reported alone as the underlying cause in only 1.2% of the 4,348 deaths attributed to this cause. This highlights that conditions which are more likely to experience an acute onset leading to death such as specific influenza strains, are less likely to have multiple associated causes and comorbidities than chronic conditions such as diabetes.

External Causes

Deaths due to external causes are those which occur as a result of accidents, poisonings and/or violence. They are classified according to the event leading to the fatal injury, such as an accidental fall. Multiple cause data for external causes include the nature of injury or poisoning, as well as any other causes reported on the death certificate. ICD-10 codes in the Injury, poisoning and certain other consequences of external causes chapter (S00-T98) cannot be an underlying cause of death, but can be recorded as an associated cause.

In 2014, external causes of mortality (V01-Y98) had a mean of 4.2 causes per death. Of the 10,062 deaths due to an external cause, 99.1% (9968) of these were reported with an injury or poisoning leading directly to death. Intentional self-harm deaths (X60-X84, Y870) accounted for 28.7% (2,864) of deaths with an injury. Asphyxiation, the injury most commonly resulting from hanging, strangulation and suffocation, was the most common injury reported with suicide deaths (1,625 deaths, 56.7%). In addition, 1,974 (68.9%) of deaths due to intentional self-harm were reported with a natural disease or condition, ranging from mental health conditions, substance abuse and chronic diseases. Care should be taken in interpreting numbers of suicide deaths. For further information, see Explanatory Notes 85-92. For more detailed analysis on suicides, see the Suicides section of this publication.

Transport accidents (V01-V99, Y85) accounted for 1,402 deaths (14.1%) reported with an injury. Close to half of these transport accident deaths reported injuries involving multiple body regions (T00-T07) (651 deaths, 46.4%) and/or an injury to the head, neck or thorax (S00-S29) (663 deaths, 47.3%).


DATA CUBES

Further information on multiple causes of death is presented in the data cubes associated with this publication. These include the number of associated causes for all 3-character underlying causes, as well as the number of mentions of each cause at the 3-character level of ICD-10.