title: Clinical characteristics of aortic aneurysm and dissection as a cause of sudden death in outpatients.
abstract: OBJECTIVE
  To describe characteristics of nonhospitalized patients experiencing sudden death from aortic causes and compare with characteristics of patients experiencing nontraumatic, unexpected, outpatient death from other causes.
  
  
  METHODS
  Retrospective case-control analysis of patients aged 18 to 65 years with nontraumatic, unexpected, outpatient cardiac arrest, emergency department (ED) resuscitation attempts, and autopsy-determined cause of death. Demographics, prodromal symptoms, and arrest characteristics were examined, and univariate comparisons between patients with aortic and those with nonaortic causes of death were performed.
  
  
  RESULTS
  A total of 384 patients met inclusion criteria. Aortic pathology represented 4.4% of patients (12 dissections, 5 aneurysms). Preexisting aortic disease (n = 2) and antemortem suspicion of an aortic cause (n = 3) were uncommon. Patients with an aortic cause of death often had prodromal symptoms (53% 95% CI; 28%-77%) and hemopericardium (47% 95% CI; 23%-72%), were older, and were more likely to have a pulse in the ED, an arrest rhythm of pulseless electrical activity, and an arrest witnessed arrest by a medical provider.
  
  
  CONCLUSIONS
  In this sample of outpatients with cardiac arrest from aortic disease, death was not instantaneous, and hemopericardium was common in many patients with dissection.
authors.affiliation: Department of Emergency Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA.
authors.forename: Lauren C
authors.initials: LC
authors.lastname: Pierce
authors.forename: D Mark
authors.initials: DM
authors.lastname: Courtney
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000784:Aortic Dissection / Q000150:complications* / Q000473:pathology; D001014:Aortic Aneurysm / Q000150:complications* / Q000473:pathology; D016208:Databases, Factual; D016757:Death, Sudden, Cardiac / Q000209:etiology*; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D009657:North Carolina; D012189:Retrospective Studies; D055815:Young Adult