title: Sudden death victims <45 years: Agreement between cause of death established by the forensic physician and autopsy results.
abstract: OBJECTIVE
  The goal of this study was to ascertain accordance between cause of death established by the forensic physician and autopsy results in young sudden death victims in the Netherlands.
  
  
  METHODS
  Sudden death victims aged 1-45 years examined by forensic physicians operating in the participating regions which also underwent an autopsy between January 2006 and December 2011 were included (n = 70). Cause of death established by the forensic physician based on the external medicolegal examination was compared with autopsy findings using the ICD10-classification.
  
  
  RESULTS
  Autopsy findings revealed that the majority of sudden death victims have died from a cardiac disease (n = 51, 73%). Most of the presumed heart disease related cases were confirmed by autopsy (n = 13, 87%). On the contrary, a large number of deaths caused by circulatory diseases were not recognised by the forensic physician (n = 38, 75%). In most of these cases, the forensic physician was forced to report an undetermined cause due to the lack of a solid explanation for death. Cause of death reported by the forensic physician appeared to be in agreement with the autopsy results in 12 cases (17%).
  
  
  CONCLUSIONS
  Cause of death determination in young sudden death victims is a difficult task for forensic physicians due to the limited tools available during the medicolegal examination. An effort should be made to standardize extensive post-mortem investigation after sudden death in the young. Autopsy can provide valuable information regarding the cause of death, which is of great importance in view of the identification of inheritable diseases among decedents and their families.
authors.affiliation: Department of Epidemiology and Health Promotion, Public Health Service of Amsterdam, The Netherlands. Electronic address: mceelen@ggd.amsterdam.nl.
authors.forename: Manon
authors.initials: M
authors.lastname: Ceelen
authors.affiliation: Heart Center, Department of Cardiology, Academic Medical Center - University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Christian
authors.initials: C
authors.lastname: van der Werf
authors.affiliation: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands; Interuniversity Cardiology Institute of the Netherlands, Utrecht, The Netherlands.
authors.forename: Anneke
authors.initials: A
authors.lastname: Hendrix
authors.affiliation: Department of Forensic Medicine, Public Health Service of Groningen, Groningen, The Netherlands.
authors.forename: Tatjana
authors.initials: T
authors.lastname: Naujocks
authors.affiliation: Department of Forensic Medicine, Public Health Service of the Region of Utrecht, Zeist, The Netherlands.
authors.forename: Frits
authors.initials: F
authors.lastname: Woonink
authors.affiliation: Department of Forensic Medicine, Public Health Service of Leiden, Leiden, The Netherlands.
authors.forename: Philip
authors.initials: P
authors.lastname: de Vries
authors.affiliation: Heart Center, Department of Cardiology, Academic Medical Center - University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Allard
authors.initials: A
authors.lastname: van der Wal
authors.affiliation: Public Health Service, Department of Forensic Medicine, Amsterdam, The Netherlands.
authors.forename: Kees
authors.initials: K
authors.lastname: Das
mesh_terms: D000293:Adolescent; D000328:Adult; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D003645:Death, Sudden / Q000209:etiology* / Q000473:pathology; D003951:Diagnostic Errors; D005260:Female; D005554:Forensic Medicine; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D011237:Predictive Value of Tests; D055815:Young Adult
keywords: Agreement; Autopsy; Cause of death; External examination; Forensic physician; ICD10