Histomorphological Spectrum of Various Systems in Sudden Deaths: An Autopsy Study at a Tertiary Care Centre in Gujarat, India

Abstract

Introduction: The phenomenon of sudden death is a concern, despite tremendous technological advances in healthcare. Sudden death in adults without any past history of chronic illness is increasing worldwide and is a significant issue for medical professionals. In this modernised medical world, diagnostic tools lack precision in comparison to autopsy cause of death when it comes to finding the clinical cause of death. The World Health Organisation (WHO) defines sudden death, according to the International Classification of Diseases, version 10 (ICD10), as non violent death occurring less than 24 hours from the onset of symptoms, without any other explanation. Aim: To examine the different histomorphological changes observed in autopsy specimens of sudden deaths. Materials and Methods: This retrospective descriptive crosssectional study was conducted in the Department of Pathology at a Tertiary Care Hospital affiliated with a Medical College in South Gujarat, India. Data was collected from autopsies performed between January 2018 and December 2019, and the study was conducted from January 2020 to December 2021. A total of 430 cases of sudden death were systematically examined during the study period. The autopsy forms were used to retrieve the history, and all slides from the 430 cases were reviewed. The history, gross findings, and microscopic features were noted and entered into an Excel sheet. Results: A total of 1671 autopsies were performed during the study period, out of which 430 were sudden deaths. The most commonly affected age group was 41-50 years, with 114 cases (26.51%), followed by the 31-40 years age group with 101 cases (20.16%). Among the cases, 387 were males and 43 were females, resulting in a male-to-female ratio of 9:1. The most common cause of sudden death was cardiovascular pathology 267 (62.10%). Non cardiac causes were attributed to respiratory system involvement 79 (18.37%), followed by cases where no specific cause was identified 43 (10%), multiple system involvement 28 cases (6.51%), hepatobiliary causes 7 (1.62%), genitourinary system causes 4 (0.94%), and Central Nervous System (CNS) causes 2 (0.46%). Conclusion: The present study revealed a significant number of cases of sudden natural death. Cardiac causes were found to be the major contributor to sudden death, posing a health concern in our society. Atherosclerosis was identified as the main culprit in causing myocardial infarction. Sudden death remains a significant concern, and a meticulous postmortem and histopathological {Haematoxylin & Eosin (H&E)} examination are necessary to determine its cause. To prevent sudden natural deaths, it is essential to educate the population about the importance of undergoing annual health check-ups for early diagnosis and treatment.