An autopsy review of sudden unexpected natural deaths in a suburban nigerian population

Abstract

Introduction The pattern of sudden unexpected natural deaths (SUND) is known to reflect the disease pattern prevalent in any particular geographic location. Cardiovascular, respiratory and central nervous systems are the most common organ systems contributing to SUND. This pattern appears to be changing in Nigeria in response to the changing demographics and lifestyle. It is, therefore, vital to review the causes of SUND in a typical Nigerian population and compare these with what obtains in other places. Materials and methods Cases of sudden unexpected natural deaths seen at the OAUTHC, Ile-Ife, Nigeria over a 10-year period formed the basis of the study. Results SUND accounted for 13.4% of all medico-legal autopsies. The male to female ratio was 2.1:1 while the mean age was 43.1 years ± 19.5 SD. About 54.1% of cases were older than 40 years while only 10.1% were younger than 20 years old. Cardiovascular (28.3%), respiratory (18.2%) and central nervous system (12.6%) disorders were the leading causes of death. Hypertensive heart disease (18.2%), intracerebral haemorrhage (7.5%), chronic glomerulonephritis (6.3%), breast carcinoma (6.3%), bacterial pneumonia (6.3%), aspiration pneumonitis (5.7%) and diabetic ketoacidosis (5.0%) were the leading specific causes. About 83.1% of deaths occurred outside the hospital setting while only 16.9% of deaths occurred during hospital admission. Conclusion Although hypertension-related disorders constitute a significant proportion of SUND where the pattern is similar to other developing countries and the majority of deaths occur outside the hospital setting.