Tohoku J. Exp. Med., 1999, 189 (4)

Risk Factors and Triggers of Sudden Death in the Working Generation: An Autopsy Proven Case-Control Study

MAKIKO OWADA, YOSHIHARU AIZAWA,1 KATSUYOSHI KURIHARA,2 NAOHITO TANABE,3 TOSHIYA AIZAKI and TOHRU IZUMI

Department of Internal Medicine, 1Preventive Medicine and Public Health, and 2Legal Medicine, Kitasato University School of Medicine, Sagamihara 228-8555, and 3Department of Public Health, Niigata University School of Medicine, Niigata 951-8510

  • In Japan, studies on the risk factors of sudden death in the working generation have been rarely carried out, especially among extremely rare cases of causative disease. Thus, the present study aimed to identify the risk factors and triggers of sudden death in cases whose causes of death were definitely proven by autopsy. We investigated the legal medical records for four years from May 1994 to February 1998. Out of 271 cases, 176 patients 20 to 59 years were enrolled as cases of sudden death in the working generation. Among these, 91 cases, 52%, could be analyzed by telephone interviews from close family members. Only one examiner undertook all phone questions to the case subjects. As control subjects, 1167 persons who consulted us for a health check were employed. Of the sudden death cases, the final diagnosis in 29 cases was coronary artery disease (31.9%), 18, acute cardiac dysfunction (19.8%), 6, other cardiac diseases (6.6%), 4, acute aortic dissection (4.4%), 4, cerebrovascular disease (4.4%) and 30, other diseases (32.9%). Through conditional logistic analysis, the following risk factors emerged as candidates: Long-term stress, history of heart disease, hypertension, chest symptoms, autonomic disturbance, short-term stress and a smoking habit. Short-term stress, autonomic disturbance and a smoking habit increased the risk of sudden death due to coronary artery disease. Long-term stress was associated with an increased risk of sudden death due to acute cardiac dysfunction. It was also demonstrated that autonomic disturbance and stress were closely related to the occurrence of sudden death. Therefore, to prevent sudden death, it would be helpful to identify subjective symptoms to relieve such stress in some way.
    Key words--- sudden death; autopsy study; working people; risk factor
    © 1999 Tohoku University Medical Press

    Tohoku J. Exp. Med., 1999, 189, 245-258
    Address for reprints: Makiko Owada, M.D., Department of Internal Medicine, Kitasato University School of Medicine, 1-15-1 Kitasato, Sagamihara 228-8555, Japan.
    e-mail: owada@med.kitasato-u.ac.jp

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