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急诊科突发疑似死亡:尸检结果

Sudden Suspected Death in Emergency Department: Autopsy Results.

作者信息

Gurger Mehtap, Turkoglu Abdurrahim, Atescelik Metin, Bork Turgay, Tokdemir Mehmet, Alatas Omer Dogan, Ekingen Evren

机构信息

Department of Emergency, Fırat University Faculty of Medicine, Elazig.

Department of Forensic Medicine, Fırat University Faculty of Medicine, Elazig.

出版信息

Turk J Emerg Med. 2016 Feb 26;14(3):115-20. doi: 10.5505/1304.7361.2014.47560. eCollection 2014 Sep.

Abstract

OBJECTIVES

Sudden deaths occur within 24 hours after symptoms' onset and are caused by cardiac, neurological and pulmonary diseases. Autopsy is the gold standard in determining cause of death. In this study, death's etiology was evaluated in cases applied to our department that underwent autopsy with sudden death indication.

METHODS

This study included cases aged 18 or older with sudden, suspected, non-traumatic death applying to our department between 2008 and 2012. Patients' age, sex, death time, co-morbid diseases, initial signs, cardiac rhythm, and autopsy findings were recorded after reviewing patient charts.

RESULTS

The study included 46 patients. Mean age was 45.73±19.6. Of the cases, 84.78% applied to emergency with cardiopulmonary arrest. Thirty-two cases (69.6%) were male. The most frequent cause of death was cardiovascular diseases (52.2%), followed by central nervous system disorders (21.7%), intoxications (15.2%), and respiratory diseases (10.9%). The most common diseases were myocardial infarction (45.7%), subarachnoid hemorrhage (8.7%), and chronic obstructive pulmonary disease. There were three drug ingestions, three carbon monoxide intoxications, and one corrosive material ingestion among the intoxication cases.

CONCLUSIONS

Sudden deaths are rarely encountered. Emergency clinicians should consider cause in differential diagnosis and provide appropriate approaches at first evaluation.

摘要

目的

猝死发生在症状出现后的24小时内,由心脏、神经和肺部疾病引起。尸检是确定死因的金标准。在本研究中,对我院收治的有猝死指征且接受尸检的病例的死亡病因进行评估。

方法

本研究纳入2008年至2012年间我院收治的18岁及以上突发、疑似非创伤性死亡病例。查阅患者病历后记录患者的年龄、性别、死亡时间、合并疾病、初始体征、心律及尸检结果。

结果

本研究纳入46例患者。平均年龄为45.73±19.6岁。其中,84.78%的患者因心肺骤停就诊于急诊科。32例(69.6%)为男性。最常见的死因是心血管疾病(52.2%),其次是中枢神经系统疾病(21.7%)、中毒(15.2%)和呼吸系统疾病(10.9%)。最常见的疾病是心肌梗死(45.7%)、蛛网膜下腔出血(8.7%)和慢性阻塞性肺疾病。中毒病例中有3例药物摄入、3例一氧化碳中毒和1例腐蚀性物质摄入。

结论

猝死很少见。急诊临床医生应在鉴别诊断时考虑病因,并在初次评估时提供适当的处理方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c3ce/4909964/8188837c5d7c/gr1.jpg

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