Sudden unexpected deaths of young adults in a tertiary care hospital for a period of four years

Abstract

Introduction Sudden unexpected natural death of a young adult is rare, but has a disproportionate impact on the community. This always requires a systematic forensic autopsy. At the completion of the autopsy it is expected to have the answers for all unanswered questions. However it is a challenge to the forensic pathologist since there are many sudden deaths without significant morphological anomalies. Objective : The aim of the study was to identify the causes and characteristics of sudden death among the young adults (less than 40 years of age) Study Design : Retrospective descriptive study was done based on the reports of post mortems performed on young adults who had died suddenly and unexpectedly due to natural reasons during past 4 years. The information was gathered on a pro-forma to fulfill the objectives. The data was analyzed using SPSS statistical package version 18. Results : Out of 54 autopsies analyzed, 78 % were males. 39% of the victims were of the age group of 36 to 40 years. 33% of the victims were brought to hospital before death. In 76% of the cases, a cause of death could be identified after macroscopic autopsy examination and the percentage increased to 89% after microscopy. Microscopy revealed or confirmed the cause of death in 52% of the cases. 44% were victims of sudden cardiac death. Cause of death was unascertained at the end of all the investigations in 11% of the cases. Conclusions Cause of death has a cardiac origin in majority of sudden unexpected deaths in young adults in the sample examined. Macroscopic autopsy examination could identify a cause of death in majority while abnormalities identified at microscopic examination accounted for death in nearly half of the sudden unnatural deaths in young adults. Medico-Legal Journal of Sri Lanka 2014; 2(1) : 15-21