Epidemiological Analysis of Sudden Death in School Students.
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概要
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An epidemiological study was conducted on sudden death in students in Tokyo's 23 wards over the 20-year period from 1976 to 1995. The 255 cases were classified by year, month, status at death, school year, gender, health, causes of death, mode of treatment, and examination. Results are summarized below. Sudden death occurred at 12.8 cases a year, and changes over time were almost constant. Death occurred more often in August and to about 30% of students while at school. Of these, death occurred in about 60% during sports. The male-to-female ratio was 2:1. The ratio of those who viewed themselves as healthy (healthy) and those with an indicative medsical history (diseased), possibly leading to death was about 1:1. The causes of death were acute heart failure in 63, bronchial asthma in 34, and myocarditis in 22 cases, in decreasing order. In the healthy group, the most frequent causes of death were acute heart failure, myocarditis, intracranial hemorrhage, subarachnoid hemorrhage, and digestive tract disease. In myocarditis, digestive tract diseases, and bronchial asthma, death occurred more often during medical treatment. In ischemic cardiac disease, death occurred more often during sports, while in hypertrophic cardiomyopathy, death was occurred more often during walking. In about 60% of cases, cardiopulmonary arrest was found on arrival at the hospital, and about 20% occurred while not hospitalized or after emergency admission or during medical examination. Death occurred abruptly in 117 cases (45.9%), and in 60% (23.5%) of those who had symptoms but did not receive medical examination until sudden aggravation of symptoms. Those who had symptoms and received medical examination but whose symptoms suddenly became aggravated at home numbered 37 (14.5%). Such a course was found in 60% in digestive tract diseases and 45.5% of those with myocarditis. To reduce sudden death among students, it is necessary to clarify mechanisms of sudden death from acute heart failure of unknown cause, which was found most frequently. For myocarditis, exhibiting a certain course from disease onset, it appears essential to establish reliable methodology for early diagnosis and adequate observation of the disease course.
- 一般社団法人 日本救急医学会の論文
一般社団法人 日本救急医学会 | 論文
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