Nontraumatic prehospital sudden death in young adults. Arch Intern Med 1988 Feb;148(2):303-8
Date
02/01/1988Pubmed ID
3277560DOI
10.1001/archinte.1988.00380020047010Scopus ID
2-s2.0-0023838150 (requires institutional sign-in at Scopus site) 45 CitationsAbstract
The clinical and/or autopsy records of 83 consecutive adults presenting with nontraumatic prehospital sudden death (NPSD) in a single county were reviewed. Coronary artery disease (CAD) was the primary cause of death in individuals 36 to 45 years old. Non-CAD cardiac disease was the second most common cause of NPSD in this age group. Between the ages of 18 and 35 years, non-CAD cardiac disease was the primary cause and toxic ingestions were the second most common. Patients with rhythms other than ventricular fibrillation/tachycardia, asystole, or electromechanical dissociation on presentation to the emergency room (ER) were more likely to survive. Patients with asystole in the ER were more likely to die in the ER than were patients with other rhythms. Patients with toxic ingestions tended to have a better prognosis for successful resuscitation and for ultimate survival. Age, sex, bystander cardiopulmonary resuscitation, and time in the field were not significant prognostic variables. Patients with abdominal hemorrhage (eight of 83) as the cause of NPSD may represent a subgroup for whom a special approach is warranted. None of these patients survived. Early detection by culdocentesis or paracentesis in female patients of reproductive age and nasogastric lavage or stool occult blood testing could lead to more vigorous fluid resuscitation and early surgical intervention in abdominal hemorrhage.
Author List
Raymond JR, van den Berg EK Jr, Knapp MJAuthor
John R. Raymond MD President, CEO, Professor in the President department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdolescentAdult
Coronary Disease
Death, Sudden
Female
Gastrointestinal Hemorrhage
Heart Arrest
Heart Diseases
Humans
Male
Middle Aged
North Carolina
Poisoning
Prognosis
Resuscitation
Retrospective Studies
