Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 16, 2023; 11(20): 4843-4851
Published online Jul 16, 2023. doi: 10.12998/wjcc.v11.i20.4843
Sudden death in the southern region of Saudi Arabia: A retrospective study
Ahmed Mohamed Ahmed Al-Emam, Abdulrahman Dajam, Mohammed Alrajhi, Waleed Alfaifi, Mubarak Al-Shraim, Ahmed Mohamed Helaly
Ahmed Mohamed Ahmed Al-Emam, Mubarak Al-Shraim, Department of Pathology, College of Medicine, King Khalid University, Asir 61421, Saudi Arabia
Ahmed Mohamed Ahmed Al-Emam, Ahmed Mohamed Helaly, Forensic Medicine and Clinical Toxicology, Mansoura University, Mansoura 35516, Egypt
Abdulrahman Dajam, Mohammed Alrajhi, Waleed Alfaifi, Medical School, King Khalid University, Asir 61421, Saudi Arabia
Ahmed Mohamed Helaly, Clinical Science, Faculty of Medicine, Yarmouk University, Irbid 21163, Jordan
Author contributions: Al-Emam AMA, Al-Shraim M and Helaly AM were responsible for research concept and design; Al-Emam AMA, Alrajhi M, Alfaifi W and Dajam A were responsible for collection and/or assembly of data; Al-Emam AMA, Al-Shraim M, Helaly AM, Alrajhi M, Alfaifi W and Dajam A were responsible for data analysis and interpretation; Al-Emam AMA was responsible for writing the article; Al-Emam AMA, Al-Shraim M, Helaly AM, Alrajhi M, Alfaifi W and Dajam A were responsible for critical revision of the article; Al-Emam AMA, Al-Shraim M, Helaly AM, Alrajhi M, Alfaifi W and Dajam A were responsible for final approval of the article.
Institutional review board statement: Approved by the Research Ethics Committee of College of Medicine at King Khalid University, Abha, Kingdom of Saudi Arabia, (REC # 2016-05-01).
Informed consent statement: Informed consent was not obtained as this was a retrospective study that does not show any identifying features of the subjects and hence was waived by the Research Ethics Committee of College of Medicine at King Khalid University.
Conflict-of-interest statement: The authors declare no conflict of interest.
Data sharing statement: The data that support the findings of this study are available from Asir Central Hospital but restrictions apply to the availability of these data, which were used under license for the current study, and so are not publicly available. Data are however available from the authors upon reasonable request and with permission of Asir Central Hospital.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non-commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ahmed Mohamed Ahmed Al-Emam, PhD, Associate Professor, Department of Pathology, College of Medicine, King Khalid University, Abha, P.O. Box 960, Asir, 616421, Saudi Arabia. amalemam@kku.edu.sa
Received: April 3, 2023
Peer-review started: April 3, 2023
First decision: May 31, 2023
Revised: June 8, 2023
Accepted: June 26, 2023
Article in press: June 26, 2023
Published online: July 16, 2023
ARTICLE HIGHLIGHTS
Research background

Sudden death is unanticipated, non-violent death taking place within the first 24 h after the onset of symptoms. It is a major public health problem worldwide. Moreover, the effects of living at moderate altitude on mortality are poorly understood.

Research motivation

The effects of living at moderate altitude on mortality are poorly understood. Moreover, it has been argued that living at moderate altitudes could be more protective against the development of diseases than living at high altitudes. These reported correlations on the incidence and mortality of various diseases with diverse lifestyles at different altitude levels still need further investigation.

Research objectives

To report the frequency and etiology of sudden death at Asir Central Hospital, 2255 m above sea level, in the southern region of Saudi Arabia over a period of 4 years from 2013 to 2016.

Research methods

The medical records of 1821 deaths that occurred at Asir Central Hospital over a period of four years between January, 2013 and December, 2016 were retrospectively evaluated. Death was classified into sudden and expected categories. Death was considered sudden when the patient died unexpectedly within 24 h from the onset of their ante-mortem clinical presentation. The others were classified as expected death.

Research results

The frequency of sudden death was highest among the elderly and middle-aged adults followed by infants and was highest in winter and autumn. The most important presenting symptoms prior to death were chest pain, dyspnea and fever.

Research conclusions

It is highly recommended that health care staff, in particular emergency physicians, exercise due care while managing patients presenting with these initial symptoms, particularly elderly patients, middle-aged adults and infants.

Research perspectives

Wide-scale comparisons between different altitudes as well as sea level will help address the impact of high altitude on the incidence and mortality of various diseases.