Causes of sudden unexpected deaths in young and middle-aged persons

The incidence and causes of sudden and/or unexpected deaths in the 15-49-year old population were investigated. The material was collected from 1492 cases in which either a medico-legal or a medical autopsy had been carried out. The necropsy rate was 42% of all deaths. There were 77 sudden deaths in this age-group, involving 64 males (82%) and 13 females (18%). This is 2% of all deaths and 5% of autopsied cases. The incidence per 100,000 persons in 1 year was 19.3 for males and 3.1 for females. Cardiovascular illnesses were the cause of death in 83% of cases. Coronary artery disease was the most common cause, accounting for almost half of these (49.3%). The next most common vascular cause was subarachnoidal haemorrhage (10.4%). The incidence of coronary deaths per 100,000 inhabitants in 1 year was 8.7 for males and 0.7 for females. In all cases the coronary stenosis was due to atheromatosis or more advanced atherosclerosis. Severe stenosis was located in the left descending artery in 58%, and in 52% the disease was only in one vessel. Thrombosis was found in 52%. Alcoholism (5.2%) was the next most common cause after the cardiovascular diseases. Coronary disease was very rare in age-matched victims of violent death. Deaths due to infections were rare, only 3.9%. Other solitary causes of sudden death were carcinomas, epilepsy, diabetes mellitus, intestinal occlusion and atopic dermatitis via sepsis.