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成人猝死:534例尸检系列研究及性别与对照比较

Sudden adult death: an autopsy series of 534 cases with gender and control comparison.

作者信息

Naneix Anne-Laure, Périer Marie-Cécile, Beganton Frankie, Jouven Xavier, Lorin de la Grandmaison Geoffroy

机构信息

Department of Forensic Medicine and Pathology, Raymond Poincaré Hospital, AP-HP, Versailles Saint-Quentin University 104 Boulevard Raymond Poincaré, 92380 Garches, France.

INSERM PARCC University Paris Descartes UMR-S970, Paris, France.

出版信息

J Forensic Leg Med. 2015 May;32:10-5. doi: 10.1016/j.jflm.2015.02.005. Epub 2015 Feb 17.

Abstract

The aim of our study was to highlight the epidemiological difference in adult sudden death between males and females. The type of pathologies found in adult victims of sudden death was compared to control cases in order to determine the most significant pathologies involved in sudden death. Among all autopsies performed between 1995 and 2009, 534 adult cases of sudden death and 154 cases who violently died were respectively selected. For each case, a complete autopsy was carried out, including systematic histological examination of all major organs. The sudden death population was composed of 369 males and 165 females. There was no statistical difference regarding age between males and female. Sudden death took place more often at home in women than in men (p < 0.0001). A stressful event was more frequently found in men than in women (p = 0.03). Deaths caused by cardiovascular diseases were more frequent in males than in females, especially Coronary Artery Disease (CAD) (p < 0.0001). Cardiomyopathy was more often the cause of death in women, particularly Arrythmogenic Right Ventricular Cardiomyopathy (ARVC). Cardiac pathologies were found in 45% of the control cases. CAD and ARVC were statistically more frequent in the sudden death group than in the control group. According to our study, profile of sudden death is different between males and females. Those data seem to be important for clinicians involved in prevention programs of sudden death, as they can adapt their screening according to the gender.

摘要

我们研究的目的是突出成年男性和女性猝死的流行病学差异。将成年猝死受害者中发现的病理类型与对照病例进行比较,以确定与猝死相关的最主要病理。在1995年至2009年进行的所有尸检中,分别选取了534例成年猝死病例和154例暴力死亡病例。对每个病例都进行了完整的尸检,包括对所有主要器官进行系统的组织学检查。猝死人群由369名男性和165名女性组成。男性和女性在年龄方面没有统计学差异。女性在家中发生猝死的情况比男性更常见(p < 0.0001)。男性比女性更常出现应激事件(p = 0.03)。心血管疾病导致的死亡在男性中比在女性中更常见,尤其是冠状动脉疾病(CAD)(p < 0.0001)。心肌病在女性中更常成为死亡原因,特别是致心律失常性右室心肌病(ARVC)。在45%的对照病例中发现了心脏病理。CAD和ARVC在猝死组中的发生率在统计学上高于对照组。根据我们的研究,男性和女性的猝死情况不同。这些数据对于参与猝死预防项目的临床医生似乎很重要,因为他们可以根据性别调整筛查方式。

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