Tag Archive for: cause of death

I’m Alive V2.56

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When I woke up this morning, I knew I had another year to do what I do but with more urgency. If you want to know the story, read last year’s Memo to understand. Why more urgency? Simple: I’m not any younger and while I try to age with a vengeance, the clock keeps ticking and I’ve got a lot to do. Let’s get to it.

My foray into the primary or secondary cause of death stems from a variety of sources: my once-favorite statistician, a comic, self-proclaimed gurus, and many healthcare professionals who should know better. I’m going to try to set things straight with a few examples.

The Cold

Q. Someone has a really bad cold, but a light bulb has gone out and he must get on a ladder to change it. While up on top, he sneezes, falls off the ladder, hits his head, and dies. What is the cause of death?

A. Was it the cold? The light bulb? The ladder? None of those—he died from a fall. Without those first three factors, there would have been no fall, and he’d still be miserably dealing with cold symptoms.

The Car Accident

Q. Let’s say someone is a type 2 diabetic. She is obese, has high blood pressure, and has been diagnosed with cardiovascular disease. She has a car accident; she is severely injured, loses a lot of blood, and while on the way to the hospital, she has a myocardial infarction and dies in the ambulance. What is the cause of death?

A. The loss of blood due to injuries in the car accident. The CVD may be a contributing factor, but with no accident and no blood loss, she won’t die on that day.

The Respiratory Infection

Q. Let’s keep the same person for this scenario only in this case, she catches a respiratory viral infection like the flu or respiratory syncytial virus (RSV), which has been in the news lately. She gets severe symptoms including congestion that require hospitalization. She continues to get worse, has a heart attack, and dies. What is the cause of death?

A. The cause of death is the viral infection. The obesity, the hypertension, the diabetes, and the CVD could have been contributing factors, but again, no infection and she’s still alive. You may be surprised that 6,000–10,000 people per year with CVD die due to RSV this way each year.

More
The rantings of the people I mentioned earlier shouting, “They died of their lifestyle, not of an infection!” is simply wrong. The presence of the pre-existing conditions might kill them in the next 5, 10, or 30 years, but they’d been living with those conditions for some time, and there’s no reason to think they would have died on that particular day—no infection, no death at that time. It was the infection that caused their death.

The Bottom Line

We live in a world where social media and purported health gurus overshadow science, and sometimes, common sense. There are plenty of gray areas in the interpretation of health information. Yes, we should all do better to improve every facet of our health, but we should not change the interpretation of causes of death to fit a specific narrative. That can harm us all because it may raise doubt about preventive steps we can take. In the end, it’s your body and your choice. Choose wisely.

What are you prepared to do today?

        Dr. Chet

References:
1. https://doi.org/10.1111/imj.13377
2. Biomedicines 2023. 11:71

Finding the Cause of Death

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Last week, I left you with a question about a hypothetical situation: What if my grandmother’s bedsores had become infected to the degree that it spread throughout her body; she still had congestive heart failure but didn’t have pulmonary effusion at that time. What would be the primary cause of death?

With so many health experts and influencers that get a lot of attention in social media, causes of death appear to be misunderstood. Let’s cover it as simply as I can, based on the definitions from the CDC, WHO, and other agencies around the world.

  • The primary cause of death is the situation or condition that started the chain of events resulting in death.
  • The secondary cause(s) of death are any conditions that may have contributed to the death.

In the case of the hypothetical situation, the cause of death was the systemic infection from the bedsores. The congestive heart failure was a secondary cause of death. We can’t know for certain, but the infection probably took away the ability to fight back due to the weakened condition of the cardiovascular system.

I’ll give some examples of misinformation in Saturday’s Memo—which is May 10. Long time readers will understand the significance of that day.

What are you prepared to do today?

        Dr. Chet

Statistics and Lies

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The past year has been full of opinions about the COVID-19 virus, the treatments that people claim work, and even the number of deaths from the virus. I mean, people were full of it. And still are.

The story I heard most often from a variety of people was that people died from other causes, but physicians were told to put COVID on the death certificate by hospitals—all part of a conspiracy theory to make this innocuous virus seem dangerous. Except it wasn’t an innocuous virus. It was and is dangerous, and the preliminary mortality statistics show that: 345,000 people died from the virus in 2020.

The other lie was that there were no reported deaths from heart disease because everyone who died from heart disease was assigned COVID as the cause of death. That’s a lie; 691,000 people were reported to have died from heart disease. “They would have died from heart disease anyway,” I read again and again. I don’t disagree, but the question is when? Without the added factor of COVID, they might not have died for decades.

Do we have too many people with pre-existing conditions such as heart disease, hypertension, smoking, and type 2 diabetes? Absolutely. But solving that problem requires long-term solutions. Again, without COVID, there would have been many fewer deaths.

The Bottom Line

As I’ve said from the beginning of this pandemic, there’s no reason to fear the virus. You should respect it and do the things that reduce the risk of catching it, especially now with the serious mutations that are evolving. There’s talk of infrastructure legislation coming at some point. To me, we all need to evaluate our personal infrastructure, make a plan, and get our own bodies in order. That’s the way to deal with this pandemic and the next one.

Health is a choice. Choose wisely today and every day.

What are you prepared to do today?

        Dr. Chet

Reference: JAMA. doi:10.1001/jama.2021.5469.

2020 Mortality Statistics

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The statistics on the causes of death in the U.S. always take a year or more to collect because every state and the District of Columbia forwards the death certificates with the cause of death to the National Center for Health Statistics Vital Statistics System for review and compilation. You can see why it would take a year. However, with the ongoing pandemic, it’s critical to get a provisional count of the number of deaths and the causes. You can read the JAMA Letter yourself at the link below.

The total number of deaths rose to 3,358,814, an increase of just over 500,000 people. The leading cause of death remains heart disease which rose by 31,000 deaths to 690,882. Cancer deaths decreased slightly, but cancer was still the cause of 599,000 deaths. The next cause of death was attributed to COVID-19 coming in at just over 345,000.

Were there any real surprises? Not for me. It does raise some questions, and I’ll address those on Saturday.

What are you prepared to do today?

        Dr. Chet

Reference: JAMA. doi:10.1001/jama.2021.5469