A Study of the Investigative Method of Cause of Death for Making out a Death Certificate

ABSTRACT

PURPOSE: We address investigative or analytical methods to report death in drawing up a death certificate. METHOD: This study was based on the death certificates completed at the emergency department, Kangwon University hospital, from September 2003 to August 2005. The data were collected through notices about drawing up death certificates and included the death certificate and the medical records in the emergency department. RESULTS: The research subjects were 29,059 patients who came to the emergency room during the period of study. Death certificates or medical certificates of death were issued to 793 of these. As to the place of death, 537 (72.5%) deaths occurred at home, 1 (0.1%) in medical institutions, 12 (1.6%) in public institutions, 48 (6.5%) patients was dead on arrival, 2 (0.3%) at industrial factories, 20 (2.7%) on road, 120 (16.2%) at other places and 1 (0.13%) was not defined. As to the types of death, death from disease was the highest (445, 60.1%), and death from external causes was next (168, 22.7%), followed by death from other or unknown causes (128, 17.3%). For death from external causes, traffic accident was 24 (14.1%), poisoning was 13 (7.6%), accidental fall was 18 (10.6%), accidental drowning was 27, 15.9%), suicide was (64, 37.6%), murder was 1 (0.6%), and other was 23 (13.5%). The study on the cause of death, 92 (16.4%) of 562 patients was found to have been helped in diagnosing the cause of death. However, in the case of death from external causes, except for death from disease, 109 patients were surveyed, the study helped to identify the cause of death in only 46 (42.2%). Likewise, in 14 (60.7%) of 23 patients the study helped to identify the cause of death as sudden death. CONCLUSION: Simple X-rays and laboratory examinations were used to determine the cause of death when drawing up a death certificate, and these helped more in identifying the causes of death from external causes than in identifying the causes of death from diseases. Especially, these worked much better for sudden death.