Cause of death

Cause of death, meaning the underlying cause of death, is (a) the disease or disorder that initiates the causal chain of diseases or disorders leading directly to death (natural cause of death); (b) the circumstances of the accident or violence causing the injury that initiated the causal chain of morbid events leading directly to death (external cause of death). The causes of death are coded according to the International Statistical Classification of Diseases and Related Health (ICD10, 10th revision) of the World Health Organization.

New ICD-10 codes were issued for coronavirus disease 2019 (COVID-19).

COVID-19 - Classification and coding according to WHO guidelines

New ICD-10 codes for COVID-19:

• U07.1 COVID-19, virus identified
• U07.2 COVID-19, virus not identified
o Clinically-epidemiologically diagnosed COVID-19
▪ Probable COVID-19
▪ Suspected COVID-19

Although both categories, U07.1 (COVID-19, virus identified) and U07.2 (COVID-19, virus not identified) are suitable for cause of death coding, it is recognised that in many countries detail as to the laboratory confirmation of COVID-19 will NOT be reported on the death certificate. In the absence of this detail, it is recommended, for mortality purposes only, to code COVID-19 provisionally to U07.1 unless it is stated as “probable” or “suspected”. In that case the cause of death is coded as U07.2.

Definition for deaths due to COVID-19

A death due to COVID-19 is defined for surveillance purposes as a death resulting from a clinically compatible illness, in a probable or confirmed COVID-19 case, unless there is a clear alternative cause of death that cannot be related to COVID disease (e.g. trauma). A death due to COVID-19 may not be attributed to another disease (e.g. cancer) and should be counted independently of preexisting conditions that are suspected of triggering a severe course of COVID-19. There should be no period of complete recovery from COVID-19 between illness and death. A death due to COVID-19 may not be attributed to another disease (e.g. cancer) and should be counted independently of preexisting conditions that are suspected of triggering a severe course of COVID-19.

Other causes of death

Malignant neoplasms

Mortality caused by malignant neoplasms here refers to total mortality from malignant neoplasms (cancer) and non-malignant neoplasms classified under ICD 10-codes C00-C97 and D00-D48. The share of malignant neoplasms (cancer) is approximately 96 percent.

Cardiovascular diseases

Cardiovascular diseases is a collective term for a large number of diseases related to the heart and the circulation, such as heart infarcts, heart failure, brain hemorrhage or aneurysm of the aorta. (ICD10-codes: I00-I99).

Mental and behavioural disorders and diseases of the nervous system

A mental/behavioural disorder is a disorder in the brain which affects personality, behaviour, thinking or emotional life (ICD-10 codes: F00-F99). Diseases of the nervous system and sense organs are coded in G00-G99.

Respiratory diseases

All death causes classified under ICD 10-codes J00-J99.

Suicide

The victim has an explicit death wish and acts accordingly by taking his/her own life. These causes of death are coded in X60-X84 of the ICD-10.

Traffic accidents

A traffic death is: “a road user who has died as a result of a sudden accident on a public road on Dutch territory, related to traffic, in which at least one moving vehicle was involved. The victim died within 30 days of the accident and was a resident of the Netherlands at the time of death.”

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