Sun Z C, Yang Q K, Jia P L, Xiong X, Qu P F, Qu Y Q, Lei P P
School of Forensic Medicine, Kunming Medical University, Kunming 650500, China.
Fa Yi Xue Za Zhi. 2018 Aug;34(4):384. doi: 10.12116/j.issn.1004-5619.2018.04.008. Epub 2018 Aug 25.
To study the epidemiological and pathological features of sudden death (SD) in Yunnan Province and to provide scientific evidence for prevention and forensic identification of sudden death.
Totally 363 SD cases were collected from the autopsies between 2009 and 2017 in the Forensic Centre of Kunming Medical University. The related factors such as etiology, age, inducing factor, time interval between the onset of disease and death, morbidity season and pathological change were retrospectively analysed.
The incidence of SD in males was significantly higher than that of females. The peak age was ≥35-55 years. The mortality rate was relatively high within 6 h after the onset of disease. The season order with descending number of deaths was spring, summer, winter and autumn. The top ten causes of SD were coronary heart disease, sudden unexplained death (SUD), cerebral hemorrhage, acute hemorrhagic necrotic pancreatitis, aortic dissection rupture, cardiomyopathy, pneumonia, pulmonary thromboembolism, amniotic fluid embolism and allergy. Exercise, infusion, surgery, medication and minor injury were the most common predisposing factors of sudden coronary death. Consciousness disorder or coma, chest pain or chest tightness, and abdominal pain were the most common premortem symptoms of sudden coronary death.
The SD is more common in middle-aged males, which is the key population for the prevention of SD. For the forensic identification and prevention of SD, the attention on SUD should be paid.
研究云南省猝死的流行病学及病理特征,为猝死的预防及法医学鉴定提供科学依据。
收集昆明医科大学法医鉴定中心2009年至2017年尸检的363例猝死病例。对病因、年龄、诱发因素、发病至死亡时间间隔、发病季节及病理变化等相关因素进行回顾性分析。
男性猝死发生率显著高于女性。猝死高峰年龄为≥35 - 55岁。发病后6小时内死亡率相对较高。按死亡人数递减的季节顺序为春季、夏季、冬季和秋季。猝死的前十大原因依次为冠心病、不明原因猝死(SUD)、脑出血、急性出血坏死性胰腺炎、主动脉夹层破裂、心肌病、肺炎、肺血栓栓塞、羊水栓塞和过敏。运动、输液、手术、用药及轻微损伤是冠心病猝死最常见的诱发因素。意识障碍或昏迷、胸痛或胸闷、腹痛是冠心病猝死最常见的死前症状。
猝死在中年男性中更为常见,是预防猝死的重点人群。对于猝死的法医学鉴定及预防,应关注不明原因猝死。