A practical classification schema incorporating consideration of possible asphyxia in cases of sudden unexpected infant
- PDF / 294,142 Bytes
- 7 Pages / 595.276 x 790.866 pts Page_size
- 52 Downloads / 154 Views
ORIGINAL ARTICLE
A practical classification schema incorporating consideration of possible asphyxia in cases of sudden unexpected infant death Brad B. Randall Æ Sabbir A. Wadee Æ Mary Ann Sens Æ Hannah C. Kinney Æ Rebecca D. Folkerth Æ Hein J. Odendaal Æ Johan J. Dempers
Accepted: 12 March 2009 / Published online: 31 May 2009 Ó Humana Press 2009
Abstract Although the rate of the sudden infant death syndrome (SIDS) has decreased over the last two decades, medical examiners and coroners are increasingly unwilling to use the SIDS diagnosis, particularly when there is an unsafe sleeping environment that might pose a risk for asphyxia. In order to reliably classify the infant deaths studied in a research setting in the mixed ancestory population in Cape Town, South Africa, we tested a classification system devised by us that incorporates the uncertainty of asphyxial risks at an infant death scene. We classified sudden infant deaths as: A) SIDS (where only a trivial potential for an overt asphyxial event existed); B) Unclassified—Possibly Asphyxial-Related (when any potential for an asphyxial death existed); C) Unclassified— Non-Asphyxial-Related (e.g., hyperthermia); D) Unclassified—No autopsy and/or death scene investigation; and E) Known Cause of Death. Ten infant deaths were classified
according to the proposed schema as: SIDS, n = 2; Unclassified—Possibly Asphyxial-Related, n = 4; and Known Cause, n = 4. A conventional schema categorized the deaths as 6 cases, SIDS, and 4 cases, Known Cause, indicating that 4/6 (67%) of deaths previously classified as SIDS are considered related importantly to asphyxia and warrant their own subgroup. This new classification schema applies a simpler, more qualitative approach to asphyxial risk in infant deaths. It also allows us to test hypotheses about the role of asphyxia in sudden infant deaths, such as in brainstem defects in a range of asphyxial challenges.
B. B. Randall (&) University of South Dakota Sanford School of Medicine, 2441 Stanton Drive, Sioux Falls, SD 57103, USA e-mail: [email protected]
Introduction
S. A. Wadee J. J. Dempers Division of Forensic Medicine and Pathology, University of Stellenbosch, National Forensic Pathology Service, Stellenbosch, South Africa M. A. Sens School of Medicine and Health Sciences, University of North Dakota, Grand Forks, ND, USA H. C. Kinney R. D. Folkerth Department of Pathology, Harvard Medical School, Boston, MA, USA H. J. Odendaal University of Stellenbosch, Tygerberg, South Africa
Keywords Bed sharing Death scene investigation Overlaying Sudden infant death syndrome Sudden unexpected death in infancy Bedcovers Sleep environment Autopsy
Sudden infant death syndrome has been defined by an expert panel of pediatric and forensic pathologists as the sudden, unexpected death of an infant less than 1 year of age with onset of the fatal episode apparently occurring during sleep and that remains unexplained after a thorough investigation, including performance of a complete autopsy and review of the circumstances of de
Data Loading...
