Abstract
A clinicopathological study was performed in a total of 592 consecutively autopsied cases (244 men and 348 women) at Tokyo Yoiku-in Hospital between January, 1967 and December, 1969, to characterize the causes of death in the aged.
Direct cause of death was single in 456 cases (77%) and multiple in 136 cases (23%). Diseases of respiratory system was the leading cause of death, which amounted to 49.2%, including various kinds of pneumonias, followed by those of central nervous system (27.7%), circulatory system (15.3%), malignant neoplasm (9.6 %), those of digestive tract (9.6%) and urinary tract (8.6%). Principal underlying diseases were consistent with the direct cause of death in 383 cases (64.7%), and different in 209 cases (35.3%). Principal underlying disease was single in 463 cases (78.2%) and multiple in 129 cases (21.8%). Among them diseases of central nervous system was the highest (38.2%), followed by respiratory system (24.5%), circulatory system (23.6%), malignant neoplasm (15.5%), digestive tract (8.4%) and urinary tract (5.9%). Comparison of these results with the vital statistics in Japan showed that there was no cases of senility in our statistics, and that importance of respiratory disease as the direct cause of death in the aged group should be emphasized.
Sudden death was defined as (1) sudden death terminating within 1 hour, and (2) unexpected death terminating within 24 hours. Sudden death (38 cases) and unexpected death (65 cases) made a total of 103 cases, which corresponded to an incidence of 17.4%. Incidence of sudden death was highest in diseases of circulatory system (40.4%), followed by those of respiratory system (12.9%), and central nervous system (12.8%). Cardiac rupture (5 cases), aortic rupture (7 cases), myocardial infarction (13 cases) and valvular disease (7 cases) were the main lesions of cardiovascular origin. Essential features of respiratory disease was suffocation in sudden death and latent progress of pneumonia in unexpected death. Most of the sudden death in disease of central nervous system was unexpected, including 16 cases of bleeding. Retrospective analysis of a total of 554 electrocardiograms revealed that the incidenoes of advanced degree of A-V block, left axis deviation, right bundle branch block, myocardial infarction and ventricular premature beat were high in sudden cardiac death.
