Abstract
AIMS—To study the epidemiological, clinical, and pathological characteristics of sudden unexpected non-violent deaths between 1and 19years. METHODS—Population based observational study of all sudden unexpected non-violent deaths between 1 and 19 years, from 1990 to 1997,in a north Spain county (Bizkaia). In each case, clinical information and circumstances of death were obtained and a complete forensic autopsy was performed. RESULTS—There were 34 sudden unexpected non-violent deaths. The mortality rate was 1.7 per 100 000 persons per year (representing 9% of the mortality rate of all non-violent deaths). In 10 cases the cause of death was cardiac, in 13 cases extracardiac, and 11 cases were unexplained. In 17 cases there were no pathological antecedents and in nine cases death occurred in patients with known disorders. Syncopes prior to death were present in five cases. Exercise related deaths occurred in seven cases (mainly associated with cardiac causes). Eight cases were "death in bed".
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- Anderson R. E., Hill R. B., Broudy D. W., Key C. R., Pathak D. A population-based autopsy study of sudden, unexpected deaths from natural causes among persons 5 to 39 years old during a 12-year period. Hum Pathol. 1994 Dec;25(12):1332–1340. doi: 10.1016/0046-8177(94)90094-9. [DOI] [PubMed] [Google Scholar]
- Basso C., Frescura C., Corrado D., Muriago M., Angelini A., Daliento L., Thiene G. Congenital heart disease and sudden death in the young. Hum Pathol. 1995 Oct;26(10):1065–1072. doi: 10.1016/0046-8177(95)90267-8. [DOI] [PubMed] [Google Scholar]
- Beerman L. B., Park S. C., Fischer D. R., Fricker F. J., Mathews R. A., Neches W. H., Lenox C. C., Zuberbuhler J. R. Ventricular septal defect associated with aneurysm of the membranous septum. J Am Coll Cardiol. 1985 Jan;5(1):118–123. doi: 10.1016/s0735-1097(85)80093-0. [DOI] [PubMed] [Google Scholar]
- Benson D. W., Jr, Benditt D. G., Anderson R. W., Dunnigan A., Pritzker M. R., Kulik T. J., Zavoral J. H. Cardiac arrest in young, ostensibly healthy patients: clinical, hemodynamic, and electrophysiologic findings. Am J Cardiol. 1983 Jul;52(1):65–69. doi: 10.1016/0002-9149(83)90070-x. [DOI] [PubMed] [Google Scholar]
- Byard R. W., Becker L. E., Berry P. J., Campbell P. E., Fitzgerald K., Hilton J. M., Krous H. F., Rognum T. O. The pathological approach to sudden infant death--consensus or confusion? Recommendations from the Second SIDS Global Strategy Meeting, Stavangar, Norway, August 1994, and the Third Australasian SIDS Global Strategy Meeting, Gold Coast, Australia, May 1995. Am J Forensic Med Pathol. 1996 Jun;17(2):103–105. doi: 10.1097/00000433-199606000-00003. [DOI] [PubMed] [Google Scholar]
- Byard R. W. Mechanisms of sudden death and autopsy findings in patients with Arnold-Chiari malformation and ventriculoatrial catheters. Am J Forensic Med Pathol. 1996 Sep;17(3):260–263. doi: 10.1097/00000433-199609000-00015. [DOI] [PubMed] [Google Scholar]
- Carswell F. Thirty deaths from asthma. Arch Dis Child. 1985 Jan;60(1):25–28. doi: 10.1136/adc.60.1.25. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Champ C. S., Byard R. W. Sudden death in asthma in childhood. Forensic Sci Int. 1994 Jun 3;66(2):117–127. doi: 10.1016/0379-0738(94)90336-0. [DOI] [PubMed] [Google Scholar]
- Cohle S. D., Lie J. T. Histopathologic spectrum of the cardiac conducting tissue in traumatic and noncardiac sudden death patients under 30 years of age: an analysis of 100 cases. Anat Pathol. 1998;3:53–76. [PubMed] [Google Scholar]
- Corrado D., Basso C., Poletti A., Angelini A., Valente M., Thiene G. Sudden death in the young. Is acute coronary thrombosis the major precipitating factor? Circulation. 1994 Nov;90(5):2315–2323. doi: 10.1161/01.cir.90.5.2315. [DOI] [PubMed] [Google Scholar]
- Corrado D., Thiene G., Nava A., Rossi L., Pennelli N. Sudden death in young competitive athletes: clinicopathologic correlations in 22 cases. Am J Med. 1990 Nov;89(5):588–596. doi: 10.1016/0002-9343(90)90176-e. [DOI] [PubMed] [Google Scholar]
- Davies M. J. Unexplained death in fit young people. BMJ. 1992 Sep 5;305(6853):538–539. doi: 10.1136/bmj.305.6853.538. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Driscoll D. J., Jacobsen S. J., Porter C. J., Wollan P. C. Syncope in children and adolescents. J Am Coll Cardiol. 1997 Apr;29(5):1039–1045. doi: 10.1016/s0735-1097(97)00020-x. [DOI] [PubMed] [Google Scholar]
- Drory Y., Turetz Y., Hiss Y., Lev B., Fisman E. Z., Pines A., Kramer M. R. Sudden unexpected death in persons less than 40 years of age. Am J Cardiol. 1991 Nov 15;68(13):1388–1392. doi: 10.1016/0002-9149(91)90251-f. [DOI] [PubMed] [Google Scholar]
- Estes N. A., 3rd Sudden death in young athletes. N Engl J Med. 1995 Aug 10;333(6):380–381. doi: 10.1056/NEJM199508103330611. [DOI] [PubMed] [Google Scholar]
- Gillette P. C., Garson A., Jr Sudden cardiac death in the pediatric population. Circulation. 1992 Jan;85(1 Suppl):I64–I69. [PubMed] [Google Scholar]
- Helweg-Larsen K., Garde E. Sudden natural death in childhood. A review of forensic autopsy protocols in cases of sudden death between the ages of one and five years, 1982-1991, with a special view to sudden unexplained death. Acta Paediatr. 1993 Nov;82(11):975–978. doi: 10.1111/j.1651-2227.1993.tb12613.x. [DOI] [PubMed] [Google Scholar]
- Keeling J. W., Knowles S. A. Sudden death in childhood and adolescence. J Pathol. 1989 Nov;159(3):221–224. doi: 10.1002/path.1711590308. [DOI] [PubMed] [Google Scholar]
- Kirschner R. H., Eckner F. A., Baron R. C. The cardiac pathology of sudden, unexplained nocturnal death in Southeast Asian refugees. JAMA. 1986 Nov 21;256(19):2700–2705. [PubMed] [Google Scholar]
- Koskenvuo K. Sudden deaths among Finnish conscripts. Br Med J. 1976 Dec 11;2(6049):1413–1415. doi: 10.1136/bmj.2.6049.1413. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Koszyca B., Moore L., Byard R. W. Lethal manifestations of neurofibromatosis type 1 in childhood. Pediatr Pathol. 1993 Sep-Oct;13(5):573–581. doi: 10.3109/15513819309048245. [DOI] [PubMed] [Google Scholar]
- Kramer M. R., Drory Y., Lev B. Sudden death in young Israeli soldiers. Analysis of 83 cases. Isr J Med Sci. 1989 Nov;25(11):620–624. [PubMed] [Google Scholar]
- Lambert E. C., Menon V. A., Wagner H. R., Vlad P. Sudden unexpected death from cardiovascular disease in children. A cooperative international study. Am J Cardiol. 1974 Jul;34(1):89–96. doi: 10.1016/0002-9149(74)90098-8. [DOI] [PubMed] [Google Scholar]
- Liberthson R. R. Sudden death from cardiac causes in children and young adults. N Engl J Med. 1996 Apr 18;334(16):1039–1044. doi: 10.1056/NEJM199604183341607. [DOI] [PubMed] [Google Scholar]
- Maron B. J., Roberts W. C., McAllister H. A., Rosing D. R., Epstein S. E. Sudden death in young athletes. Circulation. 1980 Aug;62(2):218–229. doi: 10.1161/01.cir.62.2.218. [DOI] [PubMed] [Google Scholar]
- Maron B. J., Shirani J., Poliac L. C., Mathenge R., Roberts W. C., Mueller F. O. Sudden death in young competitive athletes. Clinical, demographic, and pathological profiles. JAMA. 1996 Jul 17;276(3):199–204. [PubMed] [Google Scholar]
- McLaran C. J., Gersh B. J., Sugrue D. D., Hammill S. C., Zinsmeister A. R., Wood D. L., Holmes D. R., Jr, Osborn M. J. Out-of-hospital cardiac arrest in patients without clinically significant coronary artery disease: comparison of clinical, electrophysiological, and survival characteristics with those in similar patients who have clinically significant coronary artery disease. Br Heart J. 1987 Dec;58(6):583–591. doi: 10.1136/hrt.58.6.583. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Molander N. Sudden natural death in later childhood and adolescence. Arch Dis Child. 1982 Aug;57(8):572–576. doi: 10.1136/adc.57.8.572. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Munger R. G. Sudden death in sleep of Laotian-Hmong refugees in Thailand: a case-control study. Am J Public Health. 1987 Sep;77(9):1187–1190. doi: 10.2105/ajph.77.9.1187. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Myerburg R. J. Sudden cardiac death in persons with normal (or near normal) hearts. Am J Cardiol. 1997 Mar 20;79(6A):3–9. doi: 10.1016/s0002-9149(97)00112-4. [DOI] [PubMed] [Google Scholar]
- Nademanee K. Sudden unexplained death syndrome in Southeast Asia. Am J Cardiol. 1997 Mar 20;79(6A):10–11. doi: 10.1016/s0002-9149(97)00113-6. [DOI] [PubMed] [Google Scholar]
- Neuspiel D. R., Kuller L. H. Sudden and unexpected natural death in childhood and adolescence. JAMA. 1985 Sep 13;254(10):1321–1325. [PubMed] [Google Scholar]
- Rozin L., Perper J. A., Jaffe R., Drash A. Sudden unexpected death in childhood due to unsuspected diabetes mellitus. Am J Forensic Med Pathol. 1994 Sep;15(3):251–256. [PubMed] [Google Scholar]
- Siboni A., Simonsen J. Sudden unexpected natural death in young persons. Forensic Sci Int. 1986 Jul 14;31(3):159–166. doi: 10.1016/0379-0738(86)90183-0. [DOI] [PubMed] [Google Scholar]
- Southall D. P., Stebbens V., Shinebourne E. A. Sudden and unexpected death between 1 and 5 years. Arch Dis Child. 1987 Jul;62(7):700–705. doi: 10.1136/adc.62.7.700. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Steinberger J., Lucas R. V., Jr, Edwards J. E., Titus J. L. Causes of sudden unexpected cardiac death in the first two decades of life. Am J Cardiol. 1996 May 1;77(11):992–995. doi: 10.1016/s0002-9149(96)00035-5. [DOI] [PubMed] [Google Scholar]
- Suarez-Mier M. P., Gamallo C. Atrioventricular node fetal dispersion and His bundle fragmentation of the cardiac conduction system in sudden cardiac death. J Am Coll Cardiol. 1998 Dec;32(7):1885–1890. doi: 10.1016/s0735-1097(98)00458-6. [DOI] [PubMed] [Google Scholar]
- Thiene G., Nava A., Corrado D., Rossi L., Pennelli N. Right ventricular cardiomyopathy and sudden death in young people. N Engl J Med. 1988 Jan 21;318(3):129–133. doi: 10.1056/NEJM198801213180301. [DOI] [PubMed] [Google Scholar]
- Topaz O., Edwards J. E. Pathologic features of sudden death in children, adolescents, and young adults. Chest. 1985 Apr;87(4):476–482. doi: 10.1378/chest.87.4.476. [DOI] [PubMed] [Google Scholar]
- Topaz O., Perin E., Cox M., Mallon S. M., Castellanos A., Myerburg R. J. Young adult survivors of sudden cardiac arrest: analysis of invasive evaluation of 22 subjects. Am Heart J. 1989 Aug;118(2):281–287. doi: 10.1016/0002-8703(89)90186-5. [DOI] [PubMed] [Google Scholar]
- Van Camp S. P., Bloor C. M., Mueller F. O., Cantu R. C., Olson H. G. Nontraumatic sports death in high school and college athletes. Med Sci Sports Exerc. 1995 May;27(5):641–647. [PubMed] [Google Scholar]