School of Nursing, Midwifery, and Paramedicine, University of the Sunshine Coast, 90 Sippy Downs Drive, Sippy Downs, Queensland, 4556, Australia.
Departments of Paediatrics, Child and Youth Health, and Obstetrics and Gynaecology, Faculty of Medical and Health Science, University of Auckland, Auckland, New Zealand.
Int J Legal Med. 2020 May;134(3):1015-1021. doi: 10.1007/s00414-019-02126-w. Epub 2019 Jul 17.
Despite being widely used, few studies have assessed the utility of the San Diego definition of sudden infant death syndrome (SIDS). The purpose of this study was to evaluate pathologists' application of the San Diego definition in all cases of sudden unexpected death in infancy (SUDI) that occurred in Queensland, Australia, between 2010 and 2014. Key coronial documents of 228 cases of SUDI were reviewed independently by three reviewers and classified according to the San Diego definition. Clear guidance regarding the evidentiary threshold for classification and interpretation of the San Diego definition was provided. All reviewers classified cases identically in 202 cases (88.6%). Consensus was achieved on the classification of the remaining 26 deaths following case discussion. After review, 79 cases were classified as SIDS, a one third reduction compared with the original classification, mainly due to a high probability of accidental asphyxia. The number of cases classified as undetermined (USID) almost doubled (75/228, 32.9%), and there was more than a fivefold increase in cases classified as asphyxia (43/228, 18.9%). Natural conditions decreased by approximately one third (21/228, 9.2%). This study demonstrates that with clear guidelines for interpretation, the San Diego definition can be applied reliably, with discrepancies resolved through a process of peer review.
尽管被广泛应用，但很少有研究评估圣地亚哥婴儿猝死综合征（SIDS）定义的实用性。本研究旨在评估病理学家在 2010 年至 2014 年期间澳大利亚昆士兰州所有意外婴儿猝死（SUDI）病例中应用圣地亚哥定义的情况。对 228 例 SUDI 的关键验尸文件进行了三位审查员的独立审查，并根据圣地亚哥定义进行了分类。提供了明确的分类和解释圣地亚哥定义的证据门槛的指导。在 202 例（88.6%）中，所有审查员都以相同的方式对病例进行分类。在对其余 26 例病例进行讨论后，达成了分类共识。审查后，79 例被归类为 SIDS，与最初的分类相比减少了三分之一，主要是由于意外窒息的可能性较高。被归类为不确定（USID）的病例数量几乎翻了一番（75/228，32.9%），被归类为窒息的病例增加了五倍多（43/228，18.9%）。自然条件下降了约三分之一（21/228，9.2%）。本研究表明，通过明确的解释指南，可以可靠地应用圣地亚哥定义，通过同行评审过程解决差异。
