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

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.

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.

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).

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.