Retrospective analysis of 769 cases of sudden cardiac death from 2006 to 2015: a forensic experience in China
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ORIGINAL ARTICLE
Retrospective analysis of 769 cases of sudden cardiac death from 2006 to 2015: a forensic experience in China Zijiao Ding 1 & Mingzhen Yang 1 & Yunyun Wang 1 & Shifan Wu 1 & Xingang Qiu 1 & Qian Liu 1
Accepted: 23 May 2017 # Springer Science+Business Media, LLC 2017
Abstract Sudden cardiac death (SCD) is a major health challenge. The records of 769 autopsy cases of SCD examined at Tongji Medicolegal Expertise Center from January 2006 to December 2015 were retrospectively reviewed. The mean age of the cases was 46 years, excluding 27 victims in whom the exact age could not be confirmed. The highest incidence of SCD occurred among the 40- to 60-year-old group (45.0%). Male preponderance was observed in SCD cases (male: female ratio: 5.0:1), and this preponderance was even higher (8.0:1) in the 10- to 20-year-old and 60- to 70-year-old groups. Death predominantly occurred in hospitals (37.4%) and outdoors (32.5%). The incidence of SCD did not differ significantly between the seasons. Coronary atherosclerotic disease (CAD) was the main cause of SCD (67.9%), followed by unexplained SCD (6.1%), myocarditis (5.7%), cardiomyopathy (4.7%), rupture of aortic dissection (3.9%), and cardiac conduction system disease (3.9%). In terms of the CAD cases, the mean age was 52.0 years and coronary artery stenosis exceeding 75% accounted for 73.6% of cases. The left anterior descending branch was involved with atherosclerosis in 92.0% of cases. In conclusion, detailed autopsy and forensic pathology examination is key to diagnosing SCD. Making an early diagnosis and performing early intervention of CAD may reduce the mortality of SCD. Additionally, the use of molecular genetic tests plus forensic pathology diagnosis will help further determine the underlying cause of death in individuals with SCD.
Zijiao Ding and Mingzhen Yang contributed equally to this work. * Qian Liu [email protected] 1
Department of Forensic Medicine, Tongji Medical College of Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan 430030, China
Keywords Retrospective analysis . Sudden cardiac death . Autopsy . Coronary atherosclerotic disease . Genetic analysis
Introduction Sudden cardiac death (SCD) is defined as sudden and unpredictable death of unknown or cardiac cause; in witnessed cases, SCD is defined as an acute change in cardiovascular status with a time to death of 1.3). The criteria for heart weight were based on data on the normal heart weight of the Chinese population (284 ± 50 g in men and 258 ± 49 g in women) [6]. In addition to the above changes, myocardial fiber disorders and other morphological manifestations on histology are also important diagnostic criteria [7]. This study was approved by the institutional review board of TMECH. The following variables were analyzed: sex, age, place of death, season during which death occurred, and the cause of death. Statistical analysis Statistical analysis was performed using SPSS statistical software, version 13 (SPSS, Inc., Chicago, IL). Spearman rank correlation t
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