Krauland W
Z Rechtsmed. 1978 Mar 28;81(1):1-17. doi: 10.1007/BF00200594.
Together with the increase in motorisation sudden death at the wheel by natural causes has also gained more importance although this is not a very frequent occurrence. Scattered reports on such cases in the literature are summarized and discussed with regard to recognition, frequency, age and sex distribution, pathological changes and marginal problems, e. g. diagnostic difficulties, risk and prevention. At the top of the list of the causes of sudden natural death at the wheel are disturbances of the cardiovascular circulation and under this heading the ischemical heart diseases with 83%. The frequency peak lies in the sixties age group and in the case of the ischemical diseases generally in the seventies age group which is an indication that driving is particularly a burden for the circulation. The percentage of women (2.6%) is approx. 10 times less than it is in sudden deaths generally, this obviously being due to the fact that women in advanced years do not drive as often as men. In approx. 50% of cases the sudden natural death takes place when the vehicle is stationary. Serious accidents are seldom. Diagnostic difficulties occur when alcohol has been consumed or when in an accident caused by the sickness the victim is fatally injured or when the question of guilt is not clear. Restrictive measures will not completely prevent sudden death when driving; it is most important that a patient with a history of myocardial infarction or of advanced age should be advised of the dangers of driving by the physician treating him.
随着机动车使用的增加,因自然原因导致的驾车时猝死也变得更加突出,尽管这种情况并不常见。本文总结并讨论了文献中关于此类病例的零散报道,内容涉及识别、发生率、年龄和性别分布、病理变化以及边缘问题,如诊断困难、风险和预防等。驾车时自然猝死的首要原因是心血管循环系统紊乱,其中缺血性心脏病占83%。发病高峰年龄在60多岁,而缺血性疾病通常在70多岁,这表明驾车对循环系统尤其有负担。女性所占比例(2.6%)约为一般猝死病例的十分之一,显然这是因为老年女性驾车不如男性频繁。约50%的自然猝死发生在车辆静止时。严重事故很少。当涉及饮酒情况、因病引发事故导致受害者致命受伤或责任问题不明时,会出现诊断困难。限制措施并不能完全防止驾车时的猝死;最重要的是,治疗医生应告知有心肌梗死病史或高龄患者驾车的危险性。