Honestly, I'm not sure how many secondary factors are written on a death certificate.
Depends on how motivated the physician is when he/she is filling out the online (inTennessee) certificate. There’s nothing that states you have to list more than one.
It’s murky to say the least.
What one physician lists as cause of death might vary from another.
I don’t read anything into the CDC stat. Pretty meaningless to be honest. I probably fill out four or five death certificates a year. I try to be as complete as possible but a lot of what you put on there depends on your training and point of view.
As an example,
A 27 year old previously healthy female presents with acute tearing chest pain and right hemiplegia.
She’s found to have a Stanford Type A dissection. She undergoes ascending replacement with proximal hemiarch under deep hypothermic circulatory arrest
Unfortunately, she has a dense neurological defect on recovering from the operation.
Post op day 10 she aspirates and is reintubated with profound circulatory collapse and septic shock.
Three days after she is taken off respiratory and circulatory support and passes away.
What’s the cause of death?
I would list the Stanford Type A as the cause of death. None of the other would have happened without the dissection.
Others would list it third or fourth.
As I said, it’s murky. I cant glean any real insight from the statistics as they stand.