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Differences in investigations of sudden unexpected deaths in young people in a nationwide setting

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Abstract

Background

Inherited disease may be causative in many young sudden unexpected death cases. Autopsy is essential in the counselling of the bereaved, as the family of the victim may be at risk too. In a nationwide setting operating under the same set of laws, we hypothesized that regional differences exist in the investigation of young persons dying suddenly and unexpectedly.

Methods and results

All deaths in persons aged 1–35 years in Denmark in 2000–2006 were included. Death certificates were read independently by two physicians. External examination as well as autopsy status was retrieved. Significant regional differences were found regarding external examinations and autopsy frequencies. Ratios of conducted external examinations varied between 63% and 93% (p = 0.004). Autopsy ratios varied between 60% and 88% (p = 0.001). In urban areas, external examinations and autopsies were more often conducted than in rural areas. In East Denmark, there were more external examinations resulting in a forensic autopsy, and there was a higher overall autopsy rate compared to West Denmark.

Conclusion

Despite operating under the same set of laws, we document significant regional differences in forensic investigations of young persons suffering a sudden unexpected death. This is probably not unique for Denmark although no data exist to confirm that. The results are worrying and call for a revision of the way these deaths are handled. Mandatory autopsy in sudden unexpected death in young persons is warranted as a thorough investigation of the death may help the clinician in guidance of the relatives in relation to hereditary diseases.

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Acknowledgements

The study was funded by The Danish National Research Foundation Centre for Cardiac Arrhythmia (DARC), The John and Birthe Meyer Foundation, The Danish Heart Foundation (07-10-R60-A1751-B743-22412), The Research Foundation at the Heart Centre, Rigshospitalet, and Bønnelykkefonden.

Financial disclosures and conflicts of interest

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Authors and Affiliations

  1. The Danish National Research Foundation Centre for Cardiac Arrhythmia (DARC), Copenhagen, Denmark

    Bo Gregers Winkel, Anders Gaarsdal Holst, Juliane Theilade, Jesper Hastrup Svendsen, Stig Haunsø & Jacob Tfelt-Hansen

  2. Laboratory of Molecular Cardiology, Department of Cardiology, The Heart Centre, Copenhagen University Hospital Rigshospitalet, 2142, Blegdamsvej 9, 2100, Copenhagen O, Denmark

    Bo Gregers Winkel, Anders Gaarsdal Holst, Juliane Theilade, Henning Bundgaard, Jesper Hastrup Svendsen, Stig Haunsø & Jacob Tfelt-Hansen

  3. Department of Forensic Medicine, Aarhus University, Aarhus, Denmark

    Ingrid Bayer Kristensen

  4. Department of Forensic Medicine, University of Southern Denmark, Odense, Denmark

    Jørgen Lange Thomsen

  5. Department of Forensic Medicine, University of Copenhagen, Copenhagen, Denmark

    Hans Petter Hougen

  6. Department of Medicine and Surgery, Faculty of Health Science, University of Copenhagen, Copenhagen, Denmark

    Jesper Hastrup Svendsen & Stig Haunsø

Authors
  1. Bo Gregers Winkel
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  2. Anders Gaarsdal Holst
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  3. Juliane Theilade
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  7. Henning Bundgaard
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  8. Jesper Hastrup Svendsen
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  10. Jacob Tfelt-Hansen
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Correspondence to Bo Gregers Winkel.

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Winkel, B.G., Holst, A.G., Theilade, J. et al. Differences in investigations of sudden unexpected deaths in young people in a nationwide setting. Int J Legal Med 126, 223–229 (2012). https://doi.org/10.1007/s00414-011-0602-5

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  • DOI: https://doi.org/10.1007/s00414-011-0602-5

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