بررسي شيوع و علل مرگ هاي ناگهاني طبيعي در اصفهان

A survey of prevalence and causes of sudden natural death in Isfahan

Background & Aim: Prevention of SND (sudden natural death) is one of the unsolved problems in medicine today. Recognition and determination of causes of SND are very important preventing measurs. Materials & Methods, This is a descriptive retrospective study. 1536 cases which were referred to Isfahan legal medicine center for determination of cause of death are included in this study, then eases of SND were selected and the information gathered in a check list. Results: The rate of prevalence of SND is (7,16%). 25% of cases were between 60 and 70.77% were male. 51% had a positive drug history, 30% had a positive family history of SND and 39% had underlying diseases as follow: heart disease 25%, HTN 9%, DM 9%, respiratory sys. dis. 3% and others 1%. The most prevailing complaint was chest pain(24%) alone and (39%) accompanied with other complaints. The most prevailing cause of death diagnosed by attending physician on the basis of clinical signs and symptoms was MI (57%). A comparison between the cause of death determined after autopsy and clinical judgment showed that 60.9% of diagnoses were fully correct, 20% were partially correct and 10% were not correct .56% of cases died before admission to the hospital and before any medical intervention . Conclusion: The risk factors of SND are masculinity, older age (60-70 years), positive drug history, underlying disease and positive history of SND in the family, so it seems necessary to design studies on normal population. Because the most prevailing chief complain was chest pain it is better to plan a continuous educational programme for physicians and EMS personnel (because more than one half died before arrival). Given that two third of SND cases were without any previous disease and problem screening interventions must be done in normal and otherwise healthy populations. The discrepancies between the diagnosis of causes of death by autopsy and attending physician revealed the very important role q f clinical (hospital) autopsy film educational and research purposes and, for correct determination of cause of death.