A critical review of sudden unexpected deaths at Tygerberg Hospital Forensic Pathology Laboratory over a one-year period in 2016
Date
2021-03
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Stellenbosch : Stellenbosch University
Abstract
Background
In South Africa, admissions of sudden and unexpected deaths to large Forensic Pathology Laboratories (FPL) for
medicolegal post-mortem examination are generally on the increase. Research in this field is useful to identify disease
patterns and to reduce unnecessary admissions to forensic pathology services.
Objectives
Our main aim was to determine the recent epidemiological profile of sudden and unexpected deaths admitted to
Tygerberg FPL from 1 January to 31 December in 2016, compared to a past similar study that evaluated similar data of
2001 to 2005. A secondary objective was to ascertain the contribution of respiratory disease.
Method
A retrospective study was conducted. Anonymized data were obtained from post-mortem case files for analysis and
comparison, using an electronic Open Data Kit application, Red Cap electronic database and Windows Excel for secure
storage, and Statistical Package for Social Sciences for biostatistical analyses.
Results
The total number of cases that were admitted to Tygerberg FPL in 2016 for medicolegal post-mortem examination were
3766. The past epidemiological study at the same facility evaluating the data of 2001 to 2005, showed an annual
average of approximately 2700 admissions. Admissions of more than 1000 above the previous annual average was thus
demonstrated. Of the 3766 admissions in 2016, a sum of 770 cases comprised the study population of sudden and
unexpected deaths, of which 539 (70%) were adults and 231(30%) children. All cases that were known to have an
unnatural cause of death upon admission were excluded A younger average age of 34 years and continued male
predominance was demonstrated in the study population. The manner of death was presumably natural in 496 (64.4%)
cases, unnatural in 60 (7.8%) cases and undetermined in 214 (27.8%) cases. In the population of minors (<18 years of
age), presumed natural deaths accounted for 145/231 (62.8%) cases. Diseases of the respiratory and cardiovascular
systems continued to be the leading natural causes of death in the overall study population. Pneumonia was the most
prevalent cause of death in the population of minors (<18 years of age) and ischaemic heart disease in adults. Lower
socio-economic status areas were more significantly affected.
Conclusion
Regular epidemiologic studies of sudden and unexpected deaths are needed in Cape Town’s Eastern Metropole for
disease prevention and health promotion. Training of medical professionals and the South African Police Services is
vital to better understand what a sudden and unexpected death is and when medico-legal referral is warranted.
[370 words]
AFRIKAANSE OPSOMMING: Geen opsomming beskikbaar
AFRIKAANSE OPSOMMING: Geen opsomming beskikbaar
Description
Thesis (MMed)--Stellenbosch University, 2021.
Keywords
Respiratory diseases, UCTD, Forensic pathology, Forensic pathology -- Services, Sudden death -- Investigations, Post-mortem examinations