2004-2021年广州市338例猝死案件的流行病学特征分析

Epidemiological characteristics of 338 cases of sudden death in Guangzhou from 2004 to 2021

目的回顾性分析广州市公安局法医经办的猝死案例,揭示该地区猝死的流行病学特征,以期为相关案件的法医学死因鉴定提供新的参考数据,同时为相关公共卫生研究和决策提供可能的理论依据。方法收集广州市公安局2004-2021年的全部猝死案例,对基本案情、病历资料、法医学尸体解剖、毒化检验及组织病理学检验等资料进行回顾性分析。结果共收集到338例猝死案件,心血管疾病猝死为主要类型,占比58.58%,而心血管疾病猝死中,冠心病致死最多见(40.40%)。猝死者年龄以30~<50岁最多见,占比51.78%。总样本男女性别比为3.57∶1,差异有统计学意义(χ^(2)=106.805,P<0.01)。猝死者的死前状态呈多样化分布,其中情绪及心理波动占比最多(42.74%),其次为轻微外伤(24.19%)、饮酒和/或吸毒(12.10%)。5-9月高温(162例,占47.93%)和1月(34例,占10.06%)低温季节猝死案件多发。结论猝死病因主要类型为心血管疾病猝死,其中冠心病最多。青壮年男性猝死多见,多发于高低温季节。猝死死前状态或诱因表现多样性,但分布数量呈聚集性。

Objective To provide new reference data for forensic identification of sudden death,and to provide possible theoretical basis for public health-related research and decision-making,we retrospectively analyzed the epidemiological characteristics of sudden death in Guangzhou.Methods Cases of sudden death enrolled in Guangzhou Public Security Bureau from 2004 to 2021 were collected.Raw data of case information,clinical records,autopsy,toxicological analysis and tissue examination were retrospectively studied.Results A total of 338 cases of sudden death were collected,58.58%of them were caused by cardiovascular diseases,and coronary artery disease accounted for 40.40%of the diseases.Age between 30-<50 years accounted for 51.78%.The ratio of male:female was 3.57∶1(χ^(2)=106.805,P<0.01).Antemortem states or precipitating factors of death were diverse,but the frequency distribution showed clustering in emotional/psychological fluctuations(42.74%),slight trauma(24.19%)and alcohol/drugs(12.10%).Majority of the cases occurred in May-September(47.93%),when the weather is hot,and January(10.06%),when it’s cold.Conclusions Cardiovascular diseases were the main causes of sudden death,of which coronary artery disease was the most.Sudden death was more common in young and middle-aged men,and in high or low temperature seasons.The premortem states or precipitating factors of sudden death exhibited diversity,but the distribution was clustered.