title: The relationship of drug abuse to unexplained sudden death.
abstract: BACKGROUND
  Forensic pathologists regularly investigate the deaths of individuals with a history of drug abuse. Autopsy, including toxicology testing, reveals no cause for death in a subset of this cohort.
  
  
  OBJECTIVE
  To determine whether deaths with an undetermined cause and manner of death are associated with a history of drug abuse.
  
  
  METHODS
  Retrospective matched case-control study of 52 decedents whose cause of death remained undetermined following autopsy, matched 1:2 to a control group of living patients admitted for cholecystectomy according to age and date of death or procedure.
  
  
  RESULTS
  Individuals whose cause of death was undetermined were 5.3 times (95% confidence interval, 1.9-14.5) more likely to have a history of drug abuse than were patients with cholecystitis.
  
  
  CONCLUSIONS
  Decedents with a history of chronic drug abuse appear to be at an increased risk of dying by their chronic drug abuse, even in the absence of any anatomical or toxicologic finding at autopsy to account for death.
authors.affiliation: Southwestern Institute of Forensic Sciences, Dallas, TX, USA.
authors.forename: Amy C
authors.initials: AC
authors.lastname: Gruszecki
authors.forename: Gerald
authors.initials: G
authors.lastname: McGwin
authors.forename: C Andrew
authors.initials: CA
authors.lastname: Robinson
authors.forename: Gregory G
authors.initials: GG
authors.lastname: Davis
mesh_terms: D016022:Case-Control Studies; D002764:Cholecystitis / Q000401:mortality; D003645:Death, Sudden / Q000453:epidemiology* / Q000209:etiology*; D005260:Female; D049429:Forensic Pathology; D006801:Humans; D008297:Male; D011203:Poverty; D015995:Prevalence; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000401:mortality*