Introduction
Death is said to be sudden or unexpected when a person not known to have been suffering from any dangerous disease, injury or poisoning is found dead or dies within 24 hours after the onset of terminal illness (WHO). Some authors limit sudden deaths as those occurring instantaneously or within one hour of onset of symptoms. Emphasis is placed more on the unexpected character, rather than suddenness of death. Natural death means that the death was caused entirely by the disease, and the trauma or poison did not play any part in bringing it about.1 The study of sudden death helps in establishing the precise causes of death and enable in assisting the legal authorities in detection of crime, improve the mortality statistical data and pacify the bereaved and aggrieved relatives where the medical negligence was the sufficient ground for legal proceedings.2 The incidence is approximately 10 percent of all deaths. No period in life is exempt.1 The Size of the population limited to the jurisdiction,Attibele, Bangalore Rural district of Karnataka state in India , to this autopsy study is around 1-1.5 lakhs. The group involved individuals of all age group, Sex, religion, caste and Nationality.
In the present study analysis of all the sudden deaths referred to Forensic Medicine Department of The Oxford Medical College, Bangalore was done in order to understand the prevalence of disease process responsible for the death of the individual.
Table 1
Table 2
Systems affected
Table 3
Showing diseases and sex-wise distribution of cases
Table 4
Indicating CNS pathology
|
System |
Diseases |
Co-morbid condition |
|
Central Nervous System |
Epilepsy |
Pulomonary edema |
|
General congestion |
||
|
Meningitis |
- |
Table 5
Indicating gastro intestinal system pathology
Table 6
Indicating respiratory system pathology
Table 7
Indicating cardio vascular system pathology
Table 8
Comparison of similar studies done Else where.
Materials and Methods
The present study is a Retrospective Study, all Autopsy reports designated as Sudden and Unexpected Deaths for the period Jan 2017 to June 2022 were Collected and Studied. The Information on Cause of Death and the System Wise Pathology along with Histology reports, was obtained from the Autopsy reports besides, The Information on the circumstances and Past Medical History of the deceased were obtained from those available in the police inquest report and Hospital Records of the Respective Autopsy Records. The Information thus obtained were entered in a standard Performa and the same was analysed and studied. All Sudden Deaths wherein poisons or Unnatural causes were Excluded. onset of the terminal symptoms”.
Results
Sudden and unexpected deaths amounted to 11.61% of medico legal autopsies. Male to female rations was 16.3:1. Maximum incidence of sudden and unexpected deaths was reported above 35 yrs of age, with peak incidence between 41-50 years. Pulmonary pathology contributed 50% to major cause of sudden and unexpected deaths. The co morbid conditions associated with the leading cause of sudden natural deaths are mentioned in table no. 6.
Discussion
In the Present Retrospective Study conducted for the period 2017- June 2022, Sudden and Unexpected Natural Deaths contributed to 11.61%(n-52)(Fig-01) of the total number of Autopsies. The Observations are close to those made by V. Kumar et al.3 and Other studied else
Where,4, 5, 6 who had observed 18.8% of his cases contributing to Sudden Deaths, However majority of his victims studied were Males(87.2%).This results are close to the present study wherein Majority victims were Males(Table no 03)(Fig-02) contributing to 92.31%n-(48) of cases. All this clearly indicates the Male Preponderance in incidences of Sudden and Natural Death.7, 8, 9
In the present Study Majority of the Victims belonged to 4th Decade(Table no 01), contributing to 40.38%(n-21),this observations are similar to those made by Anand Mugadilmath et al.,2 who inferred 30.81% of his victims belonging to similar age group. This findings also are close to the observations made by Meina singh et al.10
The present study also highlights the fact that Cardiovascular System contributed(Table no 02) to the Major number of Sudden Deaths in 69.23%(n-36) of Cases, this observations are consistent with similar studies done by other Researchers else where.11, 12, 13, 14, 15, 16, 17, 18 All this indicates the fact that Cardiac Pathology is the main contributor for the Sudden and Unexpected nature of Deaths.The major comorbidites [Table no 06]observed that contributed to the underlying cause is Smoking, Obesity, Hypertension, Diabetes Mellitus and possible Life Style factor.
The Table no 3,5, 6,7 indicates the different type of Co Morbid Conditions that contributed to the Deaths.
The other major system involved in Sudden Deaths was the Respiratory System(Table no 02) contributing to 23.07%(n-12) of the Deaths, this results are close to the observations made by Anand Mugadilmath et al. 2
The Gastro Intestinal System contributed to 5.77%(n-3) of Sudden Deaths which is in contrast to the studies done by Kuller et al.19 who observed 27.7% of his Victims died due to Gastro intestinal related causes. This wide variations is possible due to the Regional, Cultural and Life Style Factors. The Table no 08 compares similar studies done else where.
This Study Highlights importance of More Research involving the Cardiovascular System to understand the Causes of Death and at the same time prevent such deaths. It also emphasises the facSt that more studies required to understand the Dominance of Male Victims.
