Pattern of sudden death at Ladoke Akintola University of Technology Teaching Hospital, Osogbo, South West Nigeria

Abstract

Background

The purpose of this study was to determine the etiology and epidemiologic characteristics of sudden death at Ladoke Akintola University of Technology (LAUTECH) Teaching Hospital, South West Nigeria.

Methods

This was a retrospective descriptive study of all cases of natural unexpected death, either occurring out of hospital or less than 24 hours after admission to LAUTECH Teaching Hospital, over a nine-year period from January 2003 to December 2011. Data were generated from information in the case notes and autopsy reports for these cases.

Results

Sudden death accounted for 29 (4.0%) of 718 adult medical deaths and 1.0% of all adult medical admissions. Out-of-hospital deaths occurred in 72.4% of cases. The mean age of the patients was 46.8 ± 11.5 (range 25–74) years. The male to female ratio was 6.25:1. Cardiovascular disease were the most common cause of death (51.7%), followed by respiratory disease (20.7%), pulmonary thromboembolism (10.4%), central nervous system disease (13.8%), gastrointestinal disorders (13.8%), severe chemical/drug poisoning (13.8%), and combined cardiovascular and central nervous system disease (13.8%). Hypertension-related causes were responsible for 14/29 (48.3%) of the sudden deaths. Hypertensive heart disease accounted for 86.7% of the cardiovascular deaths, hypertensive heart failure accounted for 73.3%, whilst all heart failure cases accounted for 80.0%. Left ventricular hypertrophy was present in 69.2% of the patients with hypertensive heart disease. Moderate to severe atheromatous changes occurred in the aorta in 38.5% of patients aged ≥50 years. No case of myocardial infarction was found.

Conclusion

Hypertensive heart disease and hypertension-related disorders are the most common causes of sudden death in South West Nigeria, so effective public health strategies should be channeled towards prevention, detection, and treatment of hypertension.

Keywords:

• sudden cardiac death
• hypertensive heart disease
• hypertensive heart failure
• left ventricular hypertrophy
• atheromatous changes

Acknowledgments

We express our sincere gratitude to Mr Asa and his team at the medical records department of LTH, Osogbo, and to the cardiology unit house officers on rotation during the period of data collection for their assistance. We also appreciate the assistance of resident doctors in the department of Morbid Anatomy and Histopathology at the hospital (especially Olabisi Aderibigbe) for assistance with data collection. Finally, we are immensely grateful to EO Asekun-Olarinmoye and WO Adebimpe, both from the Department of Community Medicine, College of Health Sciences, Osun State University, for assisting with the statistical analysis and proofreading of the manuscript.

Disclosure

The authors report no conflict of interest in this work.