Westaby Joseph D, Gabrawi Anne-Marie, Sheppard Mary N
CRY Centre for Cardiovascular Pathology, Cardiovascular Clinical Academic Group and Cardiology Research Section, Cardiovascular and Genomics Research Institute, City St. George's, University of London, London SW17 0RE, UK.
JRSM Open. 2025 Jun 2;16(6):20542704251330372. doi: 10.1177/20542704251330372. eCollection 2025 Jun.
A cause of death is a specific disease or injury which directly led to the death whereas a mode of death which is a mechanism such as respiratory failure, cardiac arrest or cardiac failure but does not provide the cause of death. We sought to establish the scale of use of cardiovascular mode and other non-specific codes as causes of death.
We extracted the mortality statistics recorded between 2013 and 2021 and then selected cardiovascular codes.
The Office for National Statistics mortality data.
Deceased individuals from England and Wales.
Cause of death.
Of 4,852,897 deaths, 836,741 (17.2%) had cardiovascular codes. Of these, 103,160 (12.3%) were labelled as modes and 35,784 (4.3%) were non-specific causes. Modes increased from 5862 in 2013 to 14,641 in 2021. Modes included 56,291 (6.7%) as arrhythmia and 46,787 (5.6%) as heart failure. Non-specific included 12,192 (1.46%) myocardial degeneration and 6573 (0.79%) cardiomegaly. Non-specific cardiomyopathies included other cardiomyopathies (207) and cardiomyopathy, unspecified (2984).
Modes of death are being used in a notable proportion of medical certificates and this is increasing which is worrying and does not provide the underlying cause of the death. It is important that a cause of death is given so that underlying heritable cardiac conditions, such as channelopathy or cardiomyopathy, are identified. This enables referral of blood relatives for cardiological screening and intervention. ICD-11 will help address some of the non-specific causes of death with the inclusion of codes for sudden arrhythmic death syndrome and arrhythmogenic cardiomyopathy. Autopsy is essential to establish a cause of death where only a mode of death can be given without clarification of a causative disease.
死因是直接导致死亡的特定疾病或损伤，而死亡方式是诸如呼吸衰竭、心脏骤停或心力衰竭等机制，但并未提供死因。我们试图确定将心血管死亡方式及其他非特异性编码用作死因的使用规模。
我们提取了2013年至2021年期间记录的死亡率统计数据，然后选择了心血管编码。
国家统计局死亡率数据办公室。
来自英格兰和威尔士的已故个体。
死因。
在4,852,897例死亡中，有836,741例（17.2%）有心血管编码。其中，103,160例（12.3%）被标记为死亡方式，35,784例（4.3%）为非特异性死因。死亡方式从2013年的5862例增加到2021年的14,641例。死亡方式包括56,291例（6.7%）为心律失常，46,787例（5.6%）为心力衰竭。非特异性包括12,192例（1.46%）心肌变性和6573例（0.79%）心脏肥大。非特异性心肌病包括其他心肌病（207例）和未特指的心肌病（2984例）。
死亡方式在相当一部分医学证明中被使用，且这种情况正在增加，这令人担忧，因为其并未提供死亡的根本原因。给出死因很重要，以便识别潜在的遗传性心脏疾病，如离子通道病或心肌病。这有助于将血亲转介进行心脏筛查和干预。《国际疾病分类第11版》（ICD - 11）将通过纳入猝死综合征和致心律失常性心肌病的编码来帮助解决一些非特异性死因。在仅给出死亡方式而未明确致病疾病的情况下，尸检对于确定死因至关重要。
