Document Detail


The role of post-mortem investigations in determining the cause of sudden unexpected death in infancy.
MedLine Citation:
PMID:  18591183     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Several autopsy protocols have been suggested for investigating sudden unexpected deaths in infancy (SUDI). The aim of this study is to provide data on the utility of such post-mortem investigations from a large paediatric autopsy series to inform future policy. METHODS: Retrospective analysis of >1500 consecutive post-mortem examinations carried out by specialist paediatric pathologists at a single centre during a 10-year period according to a common autopsy protocol that included the use of detailed ancillary investigations. SUDI was defined as the sudden unexpected death of an infant aged from 7 to 365 days. All data capture and cause of death classification were carried out according to defined criteria. RESULTS: Of 1516 paediatric post-mortem examinations, 546 presented as SUDI. In 202 infants (37%), death was explained by the autopsy findings. The other 344 cases (63%) remained unexplained. Of the explained deaths, over half (58%) were infective, most commonly due to pneumonia (22%). The component of the post-mortem examination that primarily determined the final cause of death was histological examination in 92 infants (46%), macroscopic examination in 61 (30%), microbiological investigations in 38 (19%) and clinical history in 10 (5%). CONCLUSION: This constitutes the largest single-institution autopsy study of SUDI. Ten years on from the Confidential Enquiry into Stillbirths and Deaths in Infancy (CESDI) SUDI studies, the ascertainment of a cause of death at autopsy has improved. However, with almost two thirds of SUDI remaining unexplained, alternative and/or additional diagnostic techniques are required to improve detection rates of identifiable causes of death at autopsy.
Authors:
M A Weber; M T Ashworth; R A Risdon; J C Hartley; M Malone; N J Sebire
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-06-30
Journal Detail:
Title:  Archives of disease in childhood     Volume:  93     ISSN:  1468-2044     ISO Abbreviation:  Arch. Dis. Child.     Publication Date:  2008 Dec 
Date Detail:
Created Date:  2008-11-25     Completed Date:  2009-01-05     Revised Date:  2009-02-09    
Medline Journal Info:
Nlm Unique ID:  0372434     Medline TA:  Arch Dis Child     Country:  England    
Other Details:
Languages:  eng     Pagination:  1048-53     Citation Subset:  AIM; IM    
Affiliation:
Department of Paediatric Pathology, Great Ormond Street Hospital for Children and UCL Institute of Child Health, London, UK.
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MeSH Terms
Descriptor/Qualifier:
Age Distribution
Autopsy
Female
Forensic Medicine / methods
Humans
Infant
Infant Mortality / trends*
Infant, Newborn
Male
Retrospective Studies
Sudden Infant Death / etiology*,  pathology
Comments/Corrections
Comment In:
Arch Dis Child. 2009 Feb;94(2):170-1   [PMID:  19158143 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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