Injuries and deaths among elderly persons.

Injury related to a death may be recorded on the death certificate as the underlying cause of death or as a condition associated with death but not causing it. The present study uses the National Center for Health Statistics Multiple Cause of Death data for 1978 to determine the percentage of injury-related deaths for which injury was identified as the underlying cause of death and the variation of this percentage with age at death. Injury was identified as the underlying cause of death in 86% of all cases with injury recorded on the death certificate. The percentage with injury identified as the underlying cause varied with age: 93% for those in the first year of life, 97% for those aged 1-44 years, 87% for those aged 55-64, and 50% for those aged 75 or older. The percentage with injury identified as the underlying cause also varied by cause of injury. In all age groups, assault, suicide, and motor vehicle accidents were identified as the underlying cause of death in more than 90% of the cases in which they were mentioned. Causes other than motor vehicle accidents, assaults, and suicides, especially when occurring in the elderly, were less likely to be identified as the underlying cause of death. Cause of death tabulations based only on the underlying cause of death selectively underestimate the role of injury in the deaths of the elderly.