The change in mortality is described with the comparative mortality figure (CMF), which is a ratio of the age-standardised mortality rate. The standardisation is necessary so that changes in mortality not due to the ageing of the population structure can be highlighted. The age-standardised mortality rate indicates the number of deaths per 100,000 persons of the mean population, when the age structure is kept calculatorily unchanged during the whole reference period.
The basis for an investigation of the cause of death is the information on the death certificate. The basis in law for an investigation of the cause of death is the Act on the Investigation of the Cause of Death (1973/459)
Forensic autopsy is most often performed if death has occurred in such circumstances that police investigation is necessary in order to establish the cause of death. A forensic autopsy is performed at the request of police.
A police investigation will be conducted in following situations:
A medical autopsy can be performed:
Thus, a medical autopsy is performed at the request of a physician or relatives of the deceased.
Other basis for investigating the cause of death:
The commonest other basis for an investigation of the cause of death is a clinical examination of the deceased and information on his/her latest illness or medical treatment.
The contributing cause of death is recorded in the death certificate. The doctor will report in part II of the death certificate as contributing causes of death the reasons which have adversely affected the development of the condition leading to death and hence contributed to it. The contributing cause of death can be recognised from the data, but it is not used in the compilation of annual statistics.
Deaths have to be reported immediately either to a physician or to the police. The health care unit or the physician has to report the death to the Population Information System or its maintainer (Acts 459/1973, 858/1997, 1065/2009). A death certificate is issued by a physician. In exceptional cases a report on death can be made, after consultation with a physician, by the National Institute for Health and Welfare (THL) or the police. The death certificates and reports are to be delivered to THL for checking. THL has to report deaths on which a death report has been issued to the register office which enters the information in the Population Information System (Decrees 948/1973, 99/1998, 1642/2009). During the transition period of the reform of the state regional administration the physicians supply the death certificates to be checked by the Regional State Administrative Agency. Regional State Administrative Agencies forward the death certificates to forensic pathologists in charge of THL's checking. THL is to deliver death certificates and reports to Statistics Finland monthly.
Statistics on deaths are based on data derived from the Population Register Centre's Population Information System maintained by local register offices. People who lived permanently in Finland at the time of their death are entered in the statistics on deaths in Finland. Death certificates are used at Statistics Finland for compiling cause-of-death statistics, which are published as a separate series. The number of deaths in the population statistics differs somewhat from the figure given in the statistics on causes of death compiled on the basis of death certificates.
Diseases caused by alcohol include all diseases in the classification of diseases that are caused by alcohol (categories F10, F19, G312, G4051, G621, G721, I426, K292, K70, K852, K860, O354, P043, Q860 in the International Statistical Classification of Diseases and Related Health Problems, ICD-10).
Accidental poisonings by alcohol are poisoning deaths caused by alcohol or a similar substitute (category X45).
Early neonatal mortality refers to the number of deaths during the first week of life relative to the live births during the statistical year.
General death rate indicates the number of deaths per 1,000 or 100,000 persons of the mean population.
Immediate cause of death refers to the disease, failure of injury whose symptoms cause the person to die. However, the actual mechanism of death, e.g. cardiac arrest, are not regarded as immediate causes of death. The immediate cause of death is recorded in the death certificate and saved in the statistical data files, but it is not used in the compilation of annual statistics.
Infant mortality is calculated by dividing the number of deaths of infants under one year of age by the number of live births during the statistical year. Multiplying the result by 1,000 gives the figure in per mille.
Intermediate cause of death refers to the condition which leads from the underlying cause of death to the immediate cause of death. The intermediate cause of death is recorded in the death certificate and saved in the statistical data files, but it is not used in the compilation of annual statistics.
Deaths from ischaemic heart diseases include deaths from angina pectoris, coronary thrombosis and other ischaemic heart diseases (category 27 in the national classification of diseases with 54 categories; categories I20-I25 in the International Statistical Classification of Diseases and Related Health Problems, ICD-10).
Late neonatal mortality refers to the number of deaths which occur at the age of 7 to 27 days relative to the live births during the statistical year.
Maternal mortality covers all deaths which occur during the pregnancy or during 42 days after the end of the pregnancy, regardless of the duration or location of the pregnancy. Included are all deaths of pregnant women due to any pregnancy related cause or a cause exacerbated by pregnancy, but not accidental or violent deaths. Maternal deaths are included in Chapter XV of the International Classification of Diseases. Maternal mortality is obtained by dividing the number of maternal deaths by 100,000 live-born children.
Neonatal mortality is calculated by dividing the number of deaths during the first week of life by the number of live births during the statistical year and multiplying the result by 1,000.
Perinatal mortality is calculated by dividing the number of stillbirths and deaths during the first week of life by the number of all births during the statistical year. The age during the first week is calculated in hours.
Stillbirths include a fetus or a newborn who shows no signs of life at the time of birth after a pregnancy lasting at least 22 weeks or, when the duration of the pregnancy is unknown, if the newborn weighs at least 500 grams. Miscarriages that occurred at an earlier stage of the pregnancy are not regarded as stillbirths and are not included in cause of death statistics.
The underlying cause of death is the disease which has initiated the series of illnesses leading directly to death, or the circumstances connected with an accident or an act of violence which caused the injury or poisoning leading to death. The cause of death used in statistics (the so-called statistical underlying cause of death) is determined according to the selection and application rules of the International Classification of Diseases (ICD-10) compiled by the World Health Organisation (WHO). Annual cause of death statistics are compiled according to the underlying cause of death.