Causes of Sudden Unexpected Death in Childhood: Autopsy Findings from a Specialist Centre

Objectives: To investigate the aetiologies of sudden unexpected death from natural causes in children aged 1-18 years by retrospective examination of autopsy records from a single centre. Materials and methods: The post-mortem findings from 548 children (1996-2015) were examined. Details were entered into an established research database and categorized according to >400 pre-defined criteria. Results: There were 265 previously apparently healthy children and 283 with pre-existing, potentially life-limiting, conditions. There were more males than females (M:F 1.4:1), and deaths were more frequent in the winter. Infection was commonest accounting for 43% of all deaths. Non-infectious diseases were identified as cause of death in 28%, and 29% of all deaths were unexplained. There was no significant difference in the proportions of deaths in each category between the previously healthy children and those with pre-existing conditions. Conclusion: Sudden unexpected death is a rare presentation of death in childhood and those with pre-existing conditions may be more at risk. Standardisation of the post-mortem procedure in such cases may result in more ancillary investigations performed as routine and may reduce the number of cases that are 'unexplained'.

Automated summary

This study investigates the causes of sudden unexpected death from natural causes in children aged 1-18 years through retrospective examination of autopsy records. The results show that infections are the most common cause of death, followed by non-infectious diseases, and a portion of deaths remain unexplained. There is no significant difference in the proportions of deaths between previously healthy children and those with pre-existing conditions.