title: Audit of sudden deaths in the accident and emergency department of a tertiary hospital in Trinidad and Tobago.
abstract: OBJECTIVE
  To determine the proportion of deaths due to confirmed myocardial infarction (CMI) and the aetiology of sudden death at the Port-of-Spain General Hospital (A&E) department for January to June 2008.
  
  
  METHODS
  This retrospective study utilized the death register to determine the number of A&E deaths for the study period. Patients dying from MI were investigated using records to obtain ECG and postmortem reports.
  
  
  RESULTS
  During the study period, 150 patients were certified dead in the A&E department. Cardiovascular causes accounted for 42.7% (n = 64) of deaths. Confirmed MI accounted for 27.3% (n = 41) of deaths and 3.3% (n = 5) were certified by a private practitioner without post-mortem examination and were classed as unconfirmed MI. Trauma related deaths followed with 27.3% (n = 41). Deaths from firearm injury were the next most common, 19.3% (n = 29). The mean age of patients dying from CMI was 64.1 years with a male to female ratio of 2:1. Males died from CMI on average 6.3 years before females. Mortality peaked for females in the 80 - 89-year age group while for males it was the 60- 69-year age group. Afro-Trinidadians accounted for 58.5% (n = 24) deaths due to CMI. More CMI patients had combined DM and HTN 36.6% (n = 15) than either condition alone. Afro-Trinidadians were more likely to be hypertensive and Indo-Trinidadians, diabetic. Death on arrival was the most common presentation for MI patients, 65.9% (n = 27).
  
  
  CONCLUSIONS
  This study shows that the main cause of death in the A&E Department at the Port-of-Spain General Hospital was MI. Trauma related deaths followed. Men died from MI at an earlier age than women. Most MI patients were dead on arrival.
authors.affiliation: Department of Clinical Medical Sciences, Faculty of Medical Sciences, University of the West Indies, St Augustine.
authors.forename: A
authors.initials: A
authors.lastname: Beharry
authors.forename: M
authors.initials: M
authors.lastname: Rios
authors.forename: S
authors.initials: S
authors.lastname: Sandy
authors.forename: J
authors.initials: J
authors.lastname: Chin
authors.forename: S
authors.initials: S
authors.lastname: Pooran
authors.forename: W
authors.initials: W
authors.lastname: Welch
authors.forename: T
authors.initials: T
authors.lastname: Seemungal
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D016757:Death, Sudden, Cardiac / Q000453:epidemiology*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality*; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D014300:Trinidad and Tobago / Q000453:epidemiology; D014947:Wounds and Injuries / Q000401:mortality*