Why the study?
Sudden natural deaths without autopsy are often assessed only by external examination, risking the incorrect attribution of non-cardiac causes to cardiac disease.
Sudden unexpected death is frequently attributed to cardiac causes without autopsy, but a significant proportion is due to non-cardiac etiologies such as gastrointestinal, respiratory, and vascular diseases.
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Autopsy evaluation remains essential in sudden death to avoid cardiac misattribution; this Level 3 cohort leaves open broader prevalence estimates.
Sudden death is described as a natural but unexpected death occurring within one hour from the onset of the patient's final symptoms. Despite cardiac disease being recognised as the cause of death in most people, sudden and unexpected death can also be non-cardiac related. Often a natural but sudden death is not subject to an autopsy, but only to an external examination, and this runs the risk of wrongly attributing the death to a cardiac cause. The present review is a retrospective-observational study which looks into the cases of sudden non-cardiac death recorded in the Genoa District (Italy) from 2014 to 2019 and investigated through complete autopsy examinations. Amongst these cases, 39 (31.5%) were attributable to gastrointestinal diseases, mostly due to the rupture of oesophageal varices; 39 (31.5%) to respiratory diseases, especially pulmonary infections; 31 (25%) to peripheral vascular disease, mostly attributable to pulmonary thromboembolisms or the acute dissection of aneurysms whilst the remaining 15 cases (12%) were attributable to intracranial haemorrhages.
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Drommi et al. (2021) studied this question.
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