Back to Journals » Risk Management and Healthcare Policy » Volume 3

Postmortem computed tomography is an informative approach for prevention of sudden unexpected natural death in the elderly

Authors Kaneko Toshihiro T, Miyuki Hibi, Ishibashi M, Nakatsuka A, Omori Y, Ishikura K, Hatada T, Takeda T, Takei Y, Takeda K

Published 4 May 2010 Volume 2010:3 Pages 13—20

DOI https://doi.org/10.2147/RMHP.S10260

Review by Single-blind

Peer reviewer comments 3

Toshihiro Kaneko1,2, Miyuki Hibi1, Miki Ishibashi1, Atsuhiro Nakatsuka2,3, Yukinari Omori4, Ken Ishikura4, Tsuyoshi Hatada4, Taichi Takeda4, Yoshiyuki Takei1,2, Kan Takeda3

1Department of Patient Safety, 2Autopsy Imaging Center, 3Department of Radiology, 4Emergency Department, Mie University Hospital, Japan

Introduction: Less than 10% of unnatural death cases have been examined by autopsy in Japan. In particular, the causes of death in the elderly have not yet been actively investigated. Here, we evaluated the possible use of postmortem computed tomography (PMCT) to investigate the causes of sudden unexpected natural death (SUND) in the elderly.

Methods and subjects: Death cases confirmed within 24 hours since the onset of symptoms at the Emergency Department of Mie University Hospital were defined as sudden death cases. A total of 212 sudden death cases, including 175 SUND cases, that occurred in a 3-year period from September 2006 to August 2009 were investigated.

Results and discussion: The number of sudden death cases was highest in patients in their seventies (56 cases, 26%), followed by patients in their eighties and sixties. Sudden death occurred more in men than in women in their fifties to seventies, while it occurred more in women than in men over the age of 90. PMCT was performed in more than 80% of SUND cases regardless of age of the deceased. The causes in 26 cases (27.1%) were established by PMCT, many of which were hemorrhagic diseases. Signs of aortic aneurysm rupture were detected by PMCT in the thoracic and abdominal areas of 8 patients in their seventies and over, whereas signs were absent in the younger group. Also, more than 18% of sudden death cases in patients in their seventies and over were bathing-related sudden death (BRSD). BRSD was rarely caused by hemorrhagic diseases, suggesting that a drop in blood pressure caused by bathing is an important factor in BRSD.

Conclusion: PMCT is a method that is relatively acceptable by bereaved families. It is useful for establishing the causes of approximately 30% of the SUND cases examined. The PMCT findings suggested that early detection and treatment of thoracic and abdominal aortic aneurysms and preventive measurements of bathing-related drop in blood pressure are important for the prevention of SUND in the elderly.

Keywords: sudden unexpected natural death (SUND), postmortem computed tomography (PMCT), bathing-related sudden death (BRSD)

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]

 

Readers of this article also read:

Randomized comparative trial of cervical block protocols for pain management during hysteroscopic removal of polyps and myomas

Lukes AS, Roy KH, Presthus JB, Diamond MP, Berman JM, Konsker KA

International Journal of Women's Health 2015, 7:833-839

Published Date: 13 October 2015

Emerging and future therapies for hemophilia

Carr ME, Tortella BJ

Journal of Blood Medicine 2015, 6:245-255

Published Date: 3 September 2015

A new recombinant factor VIII: from genetics to clinical use

Santagostino E

Drug Design, Development and Therapy 2014, 8:2507-2515

Published Date: 12 December 2014

Triangular model integrating clinical teaching and assessment

Abdelaziz A, Koshak E

Advances in Medical Education and Practice 2014, 5:61-64

Published Date: 4 March 2014

A novel preparation method for silicone oil nanoemulsions and its application for coating hair with silicone

Hu Z, Liao M, Chen Y, Cai Y, Meng L, Liu Y, Lv N, Liu Z, Yuan W

International Journal of Nanomedicine 2012, 7:5719-5724

Published Date: 12 November 2012

Treatment of acute otitis externa with ciprofloxacin otic 0.2% antibiotic ear solution

Mösges R, Nematian-Samani M, Eichel A

Therapeutics and Clinical Risk Management 2011, 7:325-326

Published Date: 27 July 2011

Diclofenac topical solution compared with oral diclofenac: a pooled safety analysis

Roth SH, Fuller P

Journal of Pain Research 2011, 4:159-167

Published Date: 3 June 2011

Topical diclofenac in the treatment of osteoarthritis of the knee

Niklas Schuelert, Fiona A Russell, Jason J McDougall

Orthopedic Research and Reviews 2011, 3:1-8

Published Date: 6 February 2011