Sudden cardiac death among general population and sport related population in forensic experience
Sudden cardiac death among general population and sport related population in forensic experience
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DOI：
10.1016/j.jflm.2015.07.004
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发表时间：
2015-10-01
影响因子：
1.5
通讯作者：
Michaud, Katarzyna
中科院分区：
文献类型：
--
作者：
Chappex, Nina;Schlaepfer, Juerg;Michaud, Katarzyna
目的：这项研究的目的是评估和分析洛桑法医部门转介的心脏性猝死(SCD)受害者的原因和分析，特别关注与运动相关的死亡，包括休闲体育活动。方法：这是一项基于1995年至2010年在洛桑大学法医学中心进行的10岁至50岁的SCD患者的尸检记录的回顾性研究。将研究人群分为运动相关(SR)组和非运动相关(NSR)组。结果：在研究期间，共记录到188例SCD，其中NSR 166例(88%)，非运动相关22例(12%)。188名受害者的平均年龄为37.3岁+/-10.1岁，其中大多数病例为男性(79%)。在NSR组中，平均年龄为38.2+/-9.2岁，男性占82%。冠状动脉疾病(CAD)是30-50岁患者的主要诊断。形态正常的心脏多见于15-29岁年龄段。在SR组中，91%的受害者在休闲体育活动期间死亡。在这一群体中，平均年龄为30.5岁+/-13.5岁，其中大多数是男性(82%)。主要死因为冠心病，6例(27%)，平均年龄40.8±5.5岁。最年轻的冠心病患者年仅33岁。心脏形态正常5例(23%)，平均年龄24.4±14.9岁。最常见的体育活动是徒步旅行(26%)和游泳(17%)。结论：在这项研究中，冠心病是两组人最常见的死亡原因。虽然这种病理通常影响35岁以上的成年人，但两组中也有一些35岁以下的受害者。体育期间的SCDS大多与休闲体育活动有关，对此通常还没有制定预防措施。这项研究还强调，有必要告知运动员和非运动员在体育活动中的心血管风险，以及法医尸检和法医病理学家参与的登记对SR SCD的作用。(C)2015年爱思唯尔有限公司和法医及法医学院。版权所有。
Purpose: The goal of the study was to assess the causes and analyze the cases of sudden cardiac death (SCD) victims referred to the department of forensic medicine in Lausanne, with a particular focus on sports-related fatalities including also leisure sporting activities. To date, no such published assessment has been done nor for Switzerland nor for the central Europe.Methods: This is a retrospective study based on autopsy records of SCD victims, from 10 to 50 years of age, performed at the University Centre of Legal Medicine in Lausanne from 1995 to 2010. The study population was divided into two groups: sport-related (SR) and not sport-related (NSR) SCDs.Results: During the study period, 188 cases of SCD were recorded: 166 (88%) were NSR and 22 (12%) SR. The mean age of the 188 victims was 37.3 +/- 10.1 years, with the majority of the cases being male (79%). A cause of death was established in 84%, and the pathology responsible for death varied according to the age of the victims.In the NSR group, the mean age was 38.2 +/- 9.2 years and there was 82% of male. Coronary artery disease (CAD) was the main diagnosis in the victims aged 30-50 years. The majority of morphologically normal hearts were observed in the 15-29 year age range. There was no case in the 10-14 year age range.In the SR group, 91% of victims died during leisure sporting activities. In this group the mean age was 30.5 +/- 13.5 years, with the majority being male (82%). The main cause of death was CAD, with 6 cases (27%) and a mean age of 40.8 +/- 5.5 years. The youngest victim with CAD was 33 years old. A morphologically normal heart was observed in 5 cases (23%), with a mean age of 24.4 +/- 14.9 years. The most frequently implicated sporting activities were hiking (26%) and swimming (17%).Conclusion: In this study, CAD was the most common cause of death in both groups. Although this pathology most often affects adults over 35 years of age, there were also some victims under 35 years of age in both groups. SCDs during sport are mostly related to leisure sporting activities, for which preventive measures are not yet usually established. This study highlights also the need to inform both athletes and non athletes of the cardiovascular risks during sport activities and the role of a forensic autopsy and registries involving forensic pathologists for SR SCD. (C) 2015 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.