Analysis of the causes of 9 sudden deaths and 24 deaths after short-term hospitalization using 112 consecutive autopsy cases

Abstract

Despite occasional observations of sudden or unexpected deaths and deaths occurring shortly after hospitalization, studies on sudden in-hospital deaths in adults, particularly those that have been autopsied, are scarce. This study investigated 112 consecutive autopsy cases to determine the cause of death at our hospital. The cases were divided into three groups: sudden death （death within 24h of symptom onset, regardless of the duration of hospitalization; n＝9）, short-term death （death within 2-5 days after admission, excluding sudden death; n＝24）, and others （n＝79）. No differences were observed in age, sex, season, or time of death between the groups. The sudden-death group included the following cases: aortic dissection （n＝3）, acute pneumonia （n＝2）, asphyxia （n＝2）, other cause （n＝1）, and unknown cause （n＝1）. The short-term death group, on the other hand, consisted of brain disease （n＝8）, digestive disease （n＝7）, cardiovascular disease （n＝6）, respiratory disease （n＝1）, and other causes （n＝2）. The discordance rates between the clinical and pathological diagnoses were 22.2％, 29.2％, and 44.3％ for sudden death, short-term death, and others, respectively. We found that the causes of sudden and short-term deaths were not only cardiogenic but also involved other diseases. The discordant diagnoses were aortic dissection and acute pneumonia in sudden death. Myocardial infarction was the most common cause of short-term death. To prevent sudden in-hospital deaths, not only cardiovascular diseases, such as aortic dissection and acute myocardial infarction, but also noncardiovascular ones, such as acute pneumonia, should be considered as differential diagnoses.