The Accuracy of the Death Certificate in Reporting Cause of Death in Adults

A population of 634 subjects more than 40 years of age, predominantly men, who died at two university hospitals in Denver between 1959 and 1970, were autopsied with special attention in 578 of them to the heart and lungs. The major cause of death was determined in each case, using all clinical and autopsy data. The cause of death reported to the U. S. Public Health Service by the department of public health of the state in which death occurred, based on the death certificate, was also ascertained in each case. In subjects who were determined to have died of chronic airway obstruction, chronic bronchitis or emphysema was reported as the cause of death in 76 per cent, with decreasing error over the 12-year period. In 126 well-documented cases of disabling chronic airway obstruction in patients who died without autopsy, 56 per cent were reported to have died of chronic bronchitis or emphysema. The expected rate, determined in 287 cases of disabling chronic airway obstruction, was 74 per cent. Chronic airway ...