title: Common underlying diseases do not contribute in determining the causes of sudden unexplained death.
abstract: BACKGROUND
  Underlying diseases have a statistically significant positive correlation to sudden death. However, sudden unexplained death (SUD) is different from sudden death, as there is no clinical evidence to support the sudden death due to the original underlying disease, nor a lethal pathological basis to be found during autopsy. In addition, SUD are more common in young, previously healthy individuals, usually without any signs of disease, with no positive lesions found after autopsy. Therefore, a causal relationship between SUD and the underlying disease needs to be further explored. This study aimed to explore the role that common underlying diseases play in patients with SUD and to reveal the correlation between them.
  
  
  METHODS
  The medical records, history and case information of 208 patients with SUD were collected for the survey. All these SUD occurred in the emergency room of Peking University Third Hospital from January 2006 to December 2009. The patients were stratified by with and without common underlying diseases. To examine possible associations between the underlying diseases and the cause of unexplained sudden death, the chi-squared and Fisher's exact tests were used.
  
  
  RESULTS
  Among the 208 patients, 65 were diagnosed with common underlying diseases while 143 were not. Within these two groups, there were 45 patients for whom the clear cause of death was determined. However, there were no statistically significant differences or strong associations (χ(2) = 1.238, P > 0.05) between the 11 patients with (16.90%) and 34 without (23.78%) common underlying disease among these 45 patients. We also found that occurrence of the common underlying diseases, such as neurological system, cardiovascular and pulmonary system diseases, are not statistically significant (P > 0.05) in the diagnosis of the SUD.
  
  
  CONCLUSIONS
  Common underlying diseases make no obvious contributions to SUD and are not useful in diagnosing the underlying reasons for death.
authors.affiliation: Department of Emergency Medicine, Peking University Third Hospital, Beijing 100191, China Capital Institute of Pediatrics, Beijing 100020, China.
authors.forename: Zhao-xing
authors.initials: ZX
authors.lastname: Tian
authors.forename: Yan-yu
authors.initials: YY
authors.lastname: Lü
authors.forename: Chetan Rai
authors.initials: CR
authors.lastname: Nugessur
authors.forename: Wei
authors.initials: W
authors.lastname: Yan
authors.forename: Wen-kui
authors.initials: WK
authors.lastname: Zhao
authors.forename: Li-li
authors.initials: LL
authors.lastname: Kong
authors.forename: Ya-an
authors.initials: YA
authors.lastname: Zheng
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002423:Cause of Death; D003645:Death, Sudden / Q000453:epidemiology* / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055815:Young Adult