Risk factors and triggers of sudden death in the working generation: An autopsy proven case-control study

In Japan, studies on the risk factors of sudden death in the working genera tion have been rarely carried out, especially among extremely rare cases of causative disease. Thus, the present study aimed to identify the risk fact ors and triggers of sudden death in cases whose causes of death were defini tely proven by autopsy. We investigated the legal medical records for four years from May 1994 to February 1998. Out of 271 cases, 176 patients 20 to 59 years were enrolled as cases of sudden death in the working generation. Among these, 91 cases, 52%, could be analyzed by telephone interviews from close family members. Only one examiner undertook all phone questions to th e case subjects. As control subjects, 1167 persons who consulted us for a h ealth check were employed. Of the sudden death cases, the final diagnosis i n 29 cases was coronary artery disease (31.9%), 18, acute cardiac dysfuncti on (19.8%), 6, other cardiac diseases (6.6%), 4, acute aortic dissection (4 .4%), 4, cerebrovascular disease (4.4%) and 30, other diseases (32.9%). Thr ough conditional logistic analysis, the following risk factors emerged as c andidates: Long-term stress, history of heart disease, hypertension, chest symptoms, autonomic disturbance, short-term stress and a smoking habit. Sho rt-term stress, autonomic disturbance and a smoking habit increased the ris k of sudden death due to coronary artery disease. Long-term stress wars ass ociated with an increased risk of sudden death due to acute cardiac dysfunc tion. It was also demonstrated that autonomic disturbance and stress were c losely related to the occurrence of sudden death. Therefore, to prevent sud den death, it would be helpful to identify subjective symptoms to relieve s uch stress in some way. (C) 1999 Tohoku University Medical Press.