| The role of post-mortem investigations in determining the cause of sudden unexpected death in infancy. | |
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MedLine Citation:
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PMID: 18591183 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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M A Weber; M T Ashworth; R A Risdon; J C Hartley; M Malone; N J Sebire |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2008-06-30 |
Journal Detail:
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Title: Archives of disease in childhood Volume: 93 ISSN: 1468-2044 ISO Abbreviation: Arch. Dis. Child. Publication Date: 2008 Dec |
Date Detail:
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Created Date: 2008-11-25 Completed Date: 2009-01-05 Revised Date: 2009-02-09 |
Medline Journal Info:
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Nlm Unique ID: 0372434 Medline TA: Arch Dis Child Country: England |
Other Details:
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Languages: eng Pagination: 1048-53 Citation Subset: AIM; IM |
Affiliation:
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Department of Paediatric Pathology, Great Ormond Street Hospital for Children and UCL Institute of Child Health, London, UK. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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Arch Dis Child. 2009 Feb;94(2):170-1
[PMID:
19158143
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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