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BMC Public Health Dec 2020We aim to study the profile, and pathological characteristics of sudden death in young in purpose of recommendations for prevention. (Review)
Review
BACKGROUND
We aim to study the profile, and pathological characteristics of sudden death in young in purpose of recommendations for prevention.
METHODS
We performed a retrospective cohort study using autopsy data from the Department of Forensic Medicine of Monastir (Tunisia). A review of all autopsies performed for 28 years was done (August 1990 to December 2018). In each case, clinical information, and circumstances of death were obtained. A complete forensic autopsy and histological, and toxicological investigations were performed. We have included all sudden death in persons aged between 18 and 35 years.
RESULTS
We collected 137 cases of sudden death during the studied period. The mean age of the studied population was 26.47 years. Almost 72% deaths were classified as cardiac death, and was due to ischemic heart disease in 32.32%. Sudden death was attributed to a pleuropulmonary cause in 7.4%, an abdominal cause in 6%, and from a neurological origin in 4.5%. The cause of sudden death in this group was not established by 9.5%.
CONCLUSION
In this series, sudden death in young adults occurs mainly in a smoking male, aged between 18 and 24 years old, occurring at rest, in the morning, and early in the week. It is more common, especially in summer. Sudden death is most often the first manifestation of pathologies, especially unsuspected heart diseases. The predominance of cardiovascular causes is the common denominator of almost all studies reported in the literature. Our findings suggest that prevention of sudden death among young adults under the age of 35 years should also focus on evaluation for causes not associated with structural heart disease.
Topics: Adolescent; Adult; Autopsy; Cause of Death; Death, Sudden, Cardiac; Heart Diseases; Humans; Male; Retrospective Studies; Tunisia; Young Adult
PubMed: 33334328
DOI: 10.1186/s12889-020-10012-z -
The PURPOSe cause of death study in stillbirths and neonatal deaths in India and Pakistan: A review.BJOG : An International Journal of... Nov 2023The PURPOSe study was a prospective, observational study conducted in India and Pakistan to determine the cause of death for stillbirths and preterm neonatal deaths,... (Review)
Review
The PURPOSe study was a prospective, observational study conducted in India and Pakistan to determine the cause of death for stillbirths and preterm neonatal deaths, using clinical data together with minimally invasive tissue sampling (MITS) and the histologic and polymerase chain reaction (PCR) evaluation of fetal/neonatal tissues and the placenta. After evaluating all available data, an independent panel chose a maternal, a placental and a fetal/neonatal cause of death. Here, we summarise the major results. Among the most important findings were that most stillbirths were caused by fetal asphyxia, often preceded by placental malperfusion, and clinically associated with pre-eclampsia, placental abruption and a small-for-gestational-age fetus. The preterm neonatal deaths were primarily caused by birth asphyxia, followed by various infections. An important finding was that many of the preterm neonatal deaths were caused by a nosocomial infection acquired after neonatal intensive care (NICU) admission; the most common organisms were Acinetobacter baumannii, followed by Klebsiella pneumoniae, Escherichia coli/Shigella and Haemophilus influenzae. Group B streptococcus was less commonly present in the placentas or internal organs of the neonatal deaths.
Topics: Infant, Newborn; Female; Pregnancy; Humans; Stillbirth; Perinatal Death; Prospective Studies; Pakistan; Cause of Death; Asphyxia; Placenta; India; Asphyxia Neonatorum; Observational Studies as Topic
PubMed: 37592743
DOI: 10.1111/1471-0528.17635 -
Clinics (Sao Paulo, Brazil) 2020
Topics: Alcohol Drinking; Death, Sudden; Humans; Japan; Neoplasms; Sudden Unexpected Death in Epilepsy
PubMed: 32401968
DOI: 10.6061/clinics/2020/e1770 -
The American Journal of Forensic... Jun 2022This article is a review of the fetal deaths reported to the Pima County Office of the Medical Examiner in Tucson, Arizona, from January 2000 to May 2020. The 115 cases... (Review)
Review
This article is a review of the fetal deaths reported to the Pima County Office of the Medical Examiner in Tucson, Arizona, from January 2000 to May 2020. The 115 cases included in this study were analyzed for the decedent's estimated gestational age, sex, maternal drug use, toxicology results, and cause of death. The male/female ratio was 0.95:1.0. The average gestational age of nonterm infants older than 20 weeks was 27.2 weeks. Nearly half of the cases had suspected or known maternal drug use. In these cases, cocaine and methamphetamine were most often detected in postmortem testing of the fetus. The most common causes of death in descending frequency were intrauterine fetal demise of unknown etiology, drugs, infection, and prematurity. Other notable causes of death included trauma and placental abruption. Congenital malformations were detected in only 3.5% of cases.
Topics: Coroners and Medical Examiners; Female; Fetal Death; Gestational Age; Humans; Infant; Male; Placenta; Pregnancy; Stillbirth
PubMed: 34743142
DOI: 10.1097/PAF.0000000000000726 -
Epilepsy & Behavior : E&B Feb 2020The Epilepsy Deaths Register (EDR) differs from typical registries which concentrate primarily on clinical information. It is completed by bereaved relatives and focuses... (Review)
Review
The Epilepsy Deaths Register (EDR) differs from typical registries which concentrate primarily on clinical information. It is completed by bereaved relatives and focuses on the circumstances immediately before, and the support following, a death. It can be augmented by copies of death certificates from the families of the deceased, and all epilepsy associated deaths can be entered. The EDR is underpinned by the research and experience of the SUDEP Action team and the clinical advisors who helped design the methodology and the web-based platform. The EDR has been open since 2013 and currently has over 750 entries from over 20 different countries, the majority from the United Kingdom and the Republic of Ireland. The bereaved have shown that they place their trust in the register as a vehicle to be involved in research, even under the most difficult of circumstances. As the EDR matures, we hope to identify the common and rarer patterns of epilepsy-associated death; maintaining our dual ambitions to remain committed to listen, and to make every death count. This paper is for the Special Issue: Prevent 21: SUDEP Summit - Time to Listen.
Topics: Adult; Epilepsy; Female; Humans; Ireland; Learning; Male; Registries; Sudden Unexpected Death in Epilepsy; United Kingdom
PubMed: 31431398
DOI: 10.1016/j.yebeh.2019.106454 -
JAMA Internal Medicine Dec 2023Over 580 000 people in the US experience homelessness, with one of the largest concentrations residing in San Francisco, California. Unhoused individuals have a life...
IMPORTANCE
Over 580 000 people in the US experience homelessness, with one of the largest concentrations residing in San Francisco, California. Unhoused individuals have a life expectancy of approximately 50 years, yet how sudden death contributes to this early mortality is unknown.
OBJECTIVE
To compare incidence and causes of sudden death by autopsy among housed and unhoused individuals in San Francisco County.
DESIGN, SETTING, AND PARTICIPANTS
This cohort study used data from the Postmortem Systematic Investigation of Sudden Cardiac Death (POST SCD) study, a prospective cohort of consecutive out-of-hospital cardiac arrest deaths countywide among individuals aged 18 to 90 years. Cases meeting World Health Organization criteria for presumed SCD underwent autopsy, toxicologic analysis, and medical record review. For rate calculations, all 525 incident SCDs in the initial cohort were used (February 1, 2011, to March 1, 2014). For analysis of causes, 343 SCDs (incident cases approximately every third day) were added from the extended cohort (March 1, 2014, to December 16, 2018). Data analysis was performed from July 1, 2022, to July 1, 2023.
MAIN OUTCOMES AND MEASURES
The main outcomes were incidence and causes of presumed SCD by housing status. Causes of sudden death were adjudicated as arrhythmic (potentially rescuable with implantable cardioverter-defibrillator), cardiac nonarrhythmic (eg, tamponade), or noncardiac (eg, overdose).
RESULTS
A total of 868 presumed SCDs over 8 years were identified: 151 unhoused individuals (17.4%) and 717 housed individuals (82.6%). Unhoused individuals compared with housed individuals were younger (mean [SD] age, 56.7 [0.8] vs 61.0 [0.5] years, respectively) and more often male (132 [87.4%] vs 499 [69.6%]), with statistically significant racial differences. Paramedic response times were similar (mean [SD] time to arrival, unhoused individuals: 5.6 [0.4] minutes; housed individuals: 5.6 [0.2] minutes; P = .99), while proportion of witnessed sudden deaths was lower among unhoused individuals compared with housed individuals (27 [18.0%] vs 184 [25.7%], respectively, P = .04). Unhoused individuals had higher rates of sudden death (incidence rate ratio [IRR], 16.2; 95% CI, 5.1-51.2; P < .001) and arrhythmic death (IRR, 7.2; 95% CI, 1.3-40.1; P = .02). These associations remained statistically significant after adjustment for differences in age and sex. Noncardiac causes (96 [63.6%] vs 270 [37.7%], P < .001), including occult overdose (48 [31.8%] vs 90 [12.6%], P < .001), gastrointestinal causes (8 [5.3%] vs 15 [2.1%], P = .03), and infection (11 [7.3%] vs 20 [2.8%], P = .01), were more common among sudden deaths in unhoused individuals. A lower proportion of sudden deaths in unhoused individuals were due to arrhythmic causes (48 of 151 [31.8%] vs 420 of 717 [58.6%], P < .001), including acute and chronic coronary disease.
CONCLUSIONS AND RELEVANCE
In this cohort study among individuals who experienced sudden death in San Francisco County, homelessness was associated with greater risk of sudden death from both noncardiac causes and arrhythmic causes potentially preventable with a defibrillator.
Topics: Humans; Male; Middle Aged; Incidence; Cohort Studies; Prospective Studies; Death, Sudden, Cardiac; Risk Factors; Cause of Death; Ill-Housed Persons
PubMed: 37870865
DOI: 10.1001/jamainternmed.2023.5475 -
Gene Feb 2022Sudden death is one of the major causes of death in young adults. Sudden death could be a result from both genetic and environmental or acquired factors. Understanding... (Review)
Review
Sudden death is one of the major causes of death in young adults. Sudden death could be a result from both genetic and environmental or acquired factors. Understanding the genetic etiology is crucial to prevent preventable sudden death for those who are not aware of their genetic condition. In fact, the spectrum of causes of sudden death is complex and varied. In this study, we reviewed the genes that are associated with multiple causes of sudden death in terms of both sudden cardiac death and sudden noncardiac death. A summary of genetic risk factors of the major causes of genetic relevant sudden death is also provided. We believe this review could benefit the researchers who are interested in sudden death genetic studies or the young people who are concerning about their own risk on sudden death.
Topics: Adult; Death, Sudden; Death, Sudden, Cardiac; High-Throughput Nucleotide Sequencing; Humans; Young Adult
PubMed: 34843881
DOI: 10.1016/j.gene.2021.146067 -
Cardiovascular Pathology : the Official... 2020Unexpected sudden cardiac death (SCD), sudden infant death syndrome (SIDS) and sudden intrauterine unexplained death (SIUD) are major unsolved, devastating forms of... (Review)
Review
Unexpected sudden cardiac death (SCD), sudden infant death syndrome (SIDS) and sudden intrauterine unexplained death (SIUD) are major unsolved, devastating forms of death that occur frequently. Obstructive sleep apnea (OSA) has been associated with increased cardiovascular and cerebrovascular morbidity and mortality, including sudden cardiac death (SCD). This editorial will review the pathology of SCD, including sudden infant death syndrome (SIDS) and sudden intrauterine unexplained death (SIUD); OSA with its cardiovascular consequences; the possible link between SCD and OSA, discussing the potential mechanisms underlying these two frequent, but yet overlooked pathologies. Finally, the possible preventive benefits of treating OSA and identifying patients at common risk for OSA and SCD and SIDS-SIUD to prevent unexpected deaths will be discussed. Post-mortem examination is of great importance in every case of SCD sine materia, with examination of the brainstem and cardiac conduction system on serial sections, when general autopsy fails, but it should be stressed that also the investigations of patients suffering from OSA should focus on the possibility of pathological findings in common with cases of SCD.
Topics: Brain Stem; Death, Sudden, Cardiac; Female; Fetal Death; Heart Conduction System; Humans; Infant; Infant, Newborn; Inflammation Mediators; Pregnancy; Prognosis; Risk Factors; Sleep Apnea, Obstructive; Sudden Infant Death
PubMed: 32371340
DOI: 10.1016/j.carpath.2020.107221 -
Circulation Research Jan 2021
Topics: Arrhythmias, Cardiac; Death, Sudden, Cardiac; Humans
PubMed: 33476206
DOI: 10.1161/CIRCRESAHA.120.318576 -
Population Health Metrics Feb 2021Birth registration is a child's first right. Registration of live births, stillbirths and deaths is foundational for national planning. Completeness of birth...
BACKGROUND
Birth registration is a child's first right. Registration of live births, stillbirths and deaths is foundational for national planning. Completeness of birth registration for live births in low- and middle-income countries is measured through population-based surveys which do not currently include completeness of stillbirth or death registration.
METHODS
The EN-INDEPTH population-based survey of women of reproductive age was undertaken in five Health and Demographic Surveillance System sites in Bangladesh, Ethiopia, Ghana, Guinea-Bissau and Uganda (2017-2018). In four African sites, we included new/modified questions regarding registration for 1177 stillbirths and 11,881 livebirths (1333 neonatal deaths and 10,548 surviving the neonatal period). Questions were evaluated for completeness of responses, data quality, time to administer and estimates of registration completeness using descriptive statistics. Timing of birth registration, factors associated with non-registration and reported barriers were assessed using descriptive statistics and logistic regression.
RESULTS
Almost all women, irrespective of their baby's survival, responded to registration questions, taking an average of < 1 min. Reported completeness of birth registration was 30.7% (6.1-53.5%) for babies surviving the neonatal period, compared to 1.7% for neonatal deaths (0.4-5.7%). Women were able to report age at birth registration for 93.6% of babies. Non-registration of babies surviving the neonatal period was significantly higher for home-born children (aOR 1.43 (95% CI 1.27-1.60)) and in Dabat (Ethiopia) (aOR 4.11 (95% CI 3.37-5.01)). Other socio-demographic factors associated with non-registration included younger age of mother, more prior births, little or no education, and lower socio-economic status. Neonatal death registration questions were feasible (100% women responded; only 1% did not know), revealing extremely low completeness with only 1.2% of neonatal deaths reported as registered. Despite > 70% of stillbirths occurring in facilities, only 2.5% were reported as registered.
CONCLUSIONS
Questions on birth, stillbirth and death registration were feasible in a household survey. Completeness of birth registration is low in all four sites, but stillbirth and neonatal death registration was very low. Closing the registration gap amongst facility births could increase registration of both livebirths and facility deaths, including stillbirths, but will require co-ordination between civil registration systems and the often over-stretched health sector. Investment and innovation is required to capture birth and especially deaths in both facility and community systems.
Topics: Child; Data Accuracy; Data Collection; Educational Status; Female; Humans; Infant; Infant Mortality; Infant, Newborn; Male; Perinatal Death; Pregnancy; Stillbirth
PubMed: 33557862
DOI: 10.1186/s12963-020-00231-2