Risk factors for sudden death during hospitalization

Abstract

To determine the risk factors for sudden deaths in hospitalized patients, 209 patients (103 men and 106 women, age 76.7 +/- 12.6 years old, mean +/- S.D.) who died in 1996 were divided into two groups and their records were analyzed. One group, the sudden death group (SD), consisted of 16 patients who had stayed in the hospital for 2 weeks or more before the onset of symptoms that led to death within 24 hours. Those who died more than 24 hours after symptoms began were placed into the non-sudden death group (NSD). Fourteen patients who died within 2 weeks of admission were not analyzed in this study. Comparing the data of the two groups led to the following findings. First, the major causes of death in the SD group were exacerbation of chronic cardiac failure (5 cases), acute cardiac failure (2 cases), exacerbation of chronic respiratory failure (2 cases) and acute respiratory failure (2 cases). Second, patients in the SD group were significantly older than those in the NSD group, and had significantly more prescriptions for digitalis. Third, patients in the SD group had higher levels of hemoglobin and hematocrit, lower levels of BUN and a higher cardiothoracic ratio. Fourth, patients in the SD group had a higher incidence of ST abnormalities and T wave abnormalities in their electrocardiograms. Brugada syndrome or long QT syndrome were not seen in either group. Taken together, these findings suggest that aged patients with cardiac failure and myocardial ischemia may be at higher risk of sudden death.