Sudden and Unexpected Deaths Clinical Presentation, Medical History, Autopsy Findings, and Forensic Determination of Cause of Death
Keywords:
Sudden death; unexpected death; forensic autopsy; cause of death; cardiovascular disease; coronary artery disease; histopathology; toxicology; forensic medicine.Abstract
Background: Sudden and unexpected death remains an important forensic challenge requiring integration of clinical, medical, pathological, and postmortem evidence. Objective: To assess the clinical presentation, relevant medical history, autopsy findings, and forensic determination of cause of death among cases of sudden and unexpected death. Methodology: It was a descriptive cross-sectional study which was conducted from January to December 2025. A total of 220 eligible cases were taken using consecutive sampling. The clinical records, medico-legal documentation, autopsy reports, histopathology, and toxicological examinations were used for extracting data, which were analyzed using SPSS version 26.0. Results: Of 220 cases, 151 (68.64%) were male and 69 (31.36%) females, while 57 (25.91%) were aged ≥60 years. Sudden collapse occurred in 137 (62.27%) cases and loss of consciousness in 118 (53.64%). Hypertension was documented in 61 (27.73%), diabetes mellitus in 47 (21.36%), ischemic heart disease in 39 (17.73%), and smoking in 76 (34.55%). Significant cardiac pathology was identified in 91 (41.36%) cases. Cardiovascular causes accounted for 91 (41.36%) deaths, followed by respiratory causes in 31 (14.09%) and neurological causes in 27 (12.27%). Coronary artery disease/acute coronary events were the leading specific cause, occurring in 58 (26.36%) cases. Seven (3.18%) deaths remained undetermined or unexplained. Conclusion: Cardiovascular disease was the predominant cause of sudden and unexpected death, highlighting the importance of comprehensive clinical, autopsy, histopathological, and toxicological evaluation for accurate forensic determination.
