Medicolegal investigation of sudden death in Honduras. Critical analysis of autopsies carried out in the period 2015-2019.

Abstract

Justification: Sudden death is a global public health problem. Its sudden and unexpected presentation has medico-legal implications, making its diagnostic approach in the forensic field one of great importance.
Objective: To analyze sudden death and its diagnostic approach in the Directorate of Forensic Medicine of Honduras. Methodology: The Descriptive, retrospective study of sudden death autopsies in a population aged 10 to 55 years, conducted at the Tegucigalpa headquarters during a period of five years (2015-2019). Statistical calculations were performed with the PSPP program.
Results: 165 cases of sudden death were analyzed, 56% were from a non-cardiovascular origin and 44% of cardiovascular origin, 67% male, with a mean age of 39 years, SD + / -9.75. The most frequent causes of sudden non-cardiovascular death were digestive (36%), respiratory (34%), hemorrhagic strokes (14%) and sudden death in epilepsy (9%). Among sudden cardiovascular deaths, the most frequent causes were atherosclerotic coronary artery disease (67%), myocarditis (12%) and arrhythmic death with a structurally normal heart (10%). From the toxicological point of view, the association with ethanol consumption (19%) stands out in both.
Conclusion: Sudden death of non-cardiovascular origin was the most frequent, a result conditioned by the limitations of the study. The current approach to cases of sudden death has important limitations, so it is recommended to strengthen it by implementing improvements in the medicolegal investigation at the crime scene, of family history and the appropriate use of complementary toxicological and histopathological studies.