MULTIPLE CAUSES OF DEATH - IN DETAIL

Number of Multiple Causes

For the 147,098 deaths registered in Australia in 2012, there were 465,043 causes mentioned, giving a mean of 3.2 causes per death. In 18.7% of all deaths, only one cause was reported, while 37.0% 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 2012, Malignant cancers (C00-C97) contributed to 33.0% (48,598) of all deaths as either an underlying or multiple cause. There were mentions of 59,361 malignant cancers reported in 2012.

Ischaemic heart diseases (I20-I25) which includes angina, heart attacks, and blocked arteries of the heart, were found to contribute to 24.4% 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 registered in 2012.

4.1 SELECTED MULTIPLE CAUSES OF DEATH: 2012(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	147 098	100.0	147 098	100.0	3.2
Malignant cancers (C00-C97)	42 457	28.9	48 598	33.0	1.4
Ischaemic heart diseases (I20-I25)	20 046	13.6	35 946	24.4	2.1
Cerebrovascular diseases (I60-I69)	10 779	7.3	20 075	13.6	2.0
Dementia and Alzhiemer's disease (F01, F03, G30)	10 369	7.0	22 233	15.1	2.2
Chronic lower respiratory diseases (J40-J47)	6 649	4.5	16 250	11.0	2.5
Diabetes (E10-E14)	4 239	2.9	15 093	10.3	3.6
Diseases of the kidney and urinary system (N00-N39)	3 711	2.5	20 300	13.8	6.3
Heart failure (I50, I51)	3 489	2.4	20 986	14.3	6.1
Suicides (X60-X84, Y87.0)(d)	2 535	1.7	2 535	1.7	1.0
Hypertensive diseases (I10-I15)	1 858	1.3	19 601	13.3	11.1
Influenza and pneumonia (J09-J18)	2 719	1.8	17 892	12.2	6.6
Land transport accidents (V01-V89, Y85.0)	1 411	1.0	1 474	1.0	1.0
(a) Causes of death data for 2012 are preliminary and subject to a revisions process. See Explanatory Notes 29-33 and Technical Notes, Causes of Death Revisions, 2006 in Causes of Death, Australia, 2010 and Causes of Death Revisions, 2010 and 2011 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 81-99 for further information on specific issues relating to 2012 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 92-94.

Relationships between Multiple Causes

Influenza and pneumonia (J09-J18) was identified as the underlying cause for 2,719 deaths in 2012. In 30.3% of cases, Influenza and pneumonia was reported alone.

In contrast, Diabetes (E10-E14) was reported alone as the underlying cause in only 1.5% of the 4,239 deaths attributed to this cause. It was reported most frequently with the associated causes of Ischaemic heart diseases (I20-I25) including angina, heart attacks and blocked arteries of the heart (49.6%) and Hypertensive diseases (I10-I15) (34.2%).

The following table illustrates relationships between the various causes of death in 2012. There are differences between this table and what has been published prior to 2011. For further information on these differences, see Explanatory Notes 97-98.

4.2 SELECTED UNDERLYING CAUSES WITH ASSOCIATED CAUSE: 2012(a)(b)(c)
	SELECTED UNDERLYING CAUSE		REPORTED WITH SELECTED ASSOCIATED CAUSE
	Underlying	Reported alone	Malignant cancers (C00-C97)	Ischaemic heart disease (I20-I25)	Cerebrovascular diseases (I60-I69)	Dementia and Alzheimer's disease (F01, F03, G30)	Chronic lower respiratory diseases (J40-J47)	Diabetes (E10-E14)	Diseases of the kidney and urinary system (N00-N39)	Heart failure (I50-I51)	Hypertensive diseases (I10-I15)	Influenza and pneumonia (J09-J18)
Cause of death and ICD code	no.	%	%	%	%	%	%	%	%	%	%	%
All Causes	147 098	18.7	33.0	24.4	13.6	15.1	11.0	10.3	13.8	14.3	13.3	12.2
Malignant cancers (C00-C97)	42 457	37.3	16.7	8.0	3.5	3.2	7.1	6.4	7.4	3.6	6.7	6.3
Ischaemic heart diseases (I20-I25)	20 046	10.6	7.2	27.7	9.5	11.8	10.6	12.1	13.3	28.1	21.4	5.4
Cerebrovascular diseases (I60-I69)	10 779	16.8	5.3	11.2	12.2	17.0	3.8	8.1	6.7	5.4	27.7	11.1
Dementia and Alzheimer's disease (F01, F03, G30)	10 369	12.6	5.2	12.8	9.6	6.1	4.0	8.7	12.3	7.0	13.4	27.3
Chronic lower respiratory diseases (J40-J47)	6 649	8.0	8.3	17.7	4.0	7.9	7.7	7.3	10.4	17.4	10.1	29.1
Diabetes (E10-E14)	4 239	1.5	6.6	49.6	19.9	14.8	7.6	0.8	30.7	19.4	34.2	6.7
Diseases of the kidney & urinary system (N00-N39)	3 711	8.5	5.5	21.9	6.8	10.3	6.3	10.1	24.6	23.8	5.6	10.7
Heart failure (I50-I51)	3 489	12.6	5.6	2.0	7.1	10.9	10.7	7.6	22.1	4.5	7.3	22.6
Hypertensive diseases (I10-I15)	1 858	5.3	6.8	0.6	8.0	19.4	7.1	11.7	29.6	39.0	55.7	6.8
Influenza and pneumonia (J09-J18)	2 719	30.3	1.0	16.8	2.1	2.2	2.1	7.2	11.8	5.5	6.5	1.7
(a) Causes of death data for 2012 are preliminary and subject to a revisions process. See Explanatory Notes 29-33 and Technical Notes, Causes of Death Revisions, 2006 in Causes of Death, Australia, 2010 and Causes of Death Revisions, 2010 and 2011 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 81-99 for further information on specific issues relating to 2012 and time-series data and 97-98 for an explanation of the differences between these data and what have been published previously.

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 2012, there were 14,391 deaths where External causes (V01-Y98) contributed to the death as a multiple cause. There was a mean of 3.7 causes coded for each of the 9,275 deaths with an External cause as the underlying cause of death.

In 2012, of the 9,275 deaths which had an External cause (V01-Y98) as the underlying cause of death, 98.8% (9,160) of these had an Injury or poisoning (S00-T98) as an associated cause of death. Of these 9,160 deaths, Intentional self-harm (X60-X84, Y87.0) accounted for the largest proportion, accounting for 27.7% (2,535) of deaths with an injury. Asphyxiation (T71) was the most common injury reported with suicide deaths (54.6%). Care should be taken in interpreting numbers of suicide deaths. For further information, see Explanatory Notes 92-94. For more detailed analysis on suicides, see the Suicides section.

Transport accidents (V01-V99, Y85) accounted for 16.5% of deaths with an injury as an associated cause, when considering all deaths with an underlying cause coded to an External cause of death. Close to half (48.3%) of these transport accident deaths had Injuries involving multiple body regions (T00-T07) as an associated cause, and just over a quarter (39.8%) had an injury to the head, neck and thorax (S00-S29) as an associated cause.


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.