Sudden death in the emergency department: A comprehensive 8‑year study integrating clinical and autopsy data

Tarik Akdemir; Adem Az; Yunus Doğan; Esma Akdemir

doi:10.4103/tjem.tjem_166_25

Tarik Akdemir¹, Adem Az¹, Yunus Doğan¹, Esma Akdemir²

¹Department of Emergency Medicine, Haseki Training and Research Hospital, University of Health Sciences, Istanbul, Türkiye
²Justice Ministry, Council of Forensic Medicine, Istanbul, Türkiye

Keywords: Autopsy, cardiovascular disease, emergency department, sudden death

Abstract

OBJECTIVES: This study aimed to examine the demographic and clinical characteristics of adult patients presenting with sudden, unexpected, and nontraumatic death to a high volume tertiary emergency department in Türkiye, integrating clinical records with forensic autopsy findings.

METHODS: We conducted a single center, retrospective, cross sectional study including 1555 adult patients who presented with sudden death between January 2015 and January 2023. Data were obtained from electronic medical records and forensic autopsy reports. Descriptive and inferential statistics were used to evaluate cause of death distributions by age, sex, and employment status.

RESULTS: Cardiovascular diseases (CVDs) were the leading cause of sudden death (56.7%), followed by respiratory (12.8%) and infectious diseases (11.7%). Deaths due to central nervous system (CNS) pathologies, metabolic/endocrine disorders, and intoxications occurred at significantly younger ages (P < 0.001). Males accounted for 62.1% of deaths, with CNS and respiratory related deaths being more common in males. Unemployed individuals had higher rates of infectious and CVD related deaths, while employed individuals showed a higher frequency of CNS, metabolic, and intoxication related causes (P < 0.05).

CONCLUSION: Our findings confirm that CVDs remain the most frequent cause of sudden death. However, the significant presence of noncardiac causes, especially among younger and employed individuals, highlights the need for broader preventive strategies.

How to cite this article: Akdemir T, Az A, Doğan Y, Akdemir E. Sudden death in the emergency department: Acomprehensive 8‑year study integrating clinical and autopsy data. Turk J Emerg Med 2025;25:305-12.