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URGENT CALL FOR GREATER RESEARCH INTO SO-CALLED ADULT "COT DEATH" Leading charity asks if mystery adult deaths could be just the 'tip of the iceberg'. A new study published today (March 27th) from researchers funded by the British Heart Foundation (BHF) shows that the number of people who collapse and die suddenly without explanation could be much greater than is recorded in official statistics - with the cause of these tragic deaths remaining a mystery. The disturbing new findings, featured in today's Quarterly Journal of Medicine*, show that in just over 4% of sudden deaths among apparently "previously healthy" adults under the age of 65, no cause can be found - despite a full post-mortem examination. At present, there is no nationally recognised name or category which can be used for such unexplained deaths when they are officially certified. This lack of an agreed label for the condition creates an unclear picture of the exact number of 'victims' and brings further distress to bereaved families who are left with no reason for the loss of their loved one. The survey, which involved a sample of 67 coroners across England, was carried out by a team of researchers at the National Heart & Lung Institute, London in the early 1990s. The people studied all died suddenly aged between 16 and 64 yrs, and had no previously documented heart disease, but were found at post-mortem examination to have either a cardiac cause or no identifiable cause of death. Lead researcher, Dr Tim Bowker, Associate Medical Director at the British Heart Foundation, says; "It has long been recognised that there are occasions when an apparently previously healthy adult dies suddenly and unexpectedly and any abnormalities found at post-mortem are minimal or non-existent. In such cases it can be very difficult to identify a precise cause of death. This leads us to question whether these deaths are rare or represent the tip of a larger iceberg. Our findings suggest to us that these deaths should be classed as the adult equivalent of the sudden infant death syndrome (S.I.D.S.). If the condition is more frequent that we suspect - particularly if across the country pathologists and coroners are using different words to describe the cause of death - we need to give the condition a "name" to help us gain a greater understanding of the scale of the problem." Prior experience with "cot deaths" indicates that this approach could have a major impact. Once cot death became officially labeled as the "sudden infant death syndrome", it was possible to collect and collate the relevant data, identify possible causes and take steps to protect infants from such tragedies - resulting in a 70% fall in the number of deaths over a period of 10 years (Foundation of SIDS, 2002). The new study estimates that in England, 3,500 apparently healthy adults die suddenly from cardiac or unexplained causes each year. In about 150 of these no cause can be identified, but many may be due to electrical abnormalities, some of which are inherited. However, as electrical measurements of the heart can only be made when a person is alive, any such electrical abnormalities (which might hold the vital clues to an underlying condition) cannot be detected after death. Dr Bowker adds; "Not until it is accepted practice to identify all these unexplained deaths and to label them as such, will it become possible to study them systematically, identify their causes and find ways of preventing them from occurring - and the name we propose is 'sudden adult death syndrome' or 'SADS'." The British Heart Foundation has subsequently funded a further epidemiological survey which focuses entirely on the unexplained cases, in order to gain further understanding of their causes. Medical Director of the British Heart Foundation, Professor Sir Charles George, says: "This study takes us another step closer to unravelling the mystery that surrounds the tragedy of healthy adults dying prematurely from sudden adult death. Because the 'alarm bells' only start ringing after the death of a seemingly well adult, we hope our new findings will encourage people to look back into their family's medical history and to think about whether any close relatives may have died young from unexplained causes." He adds; "At this stage, there is not sufficient evidence to back calls for population screening. What is needed is further research and accurate pathology to assess the scale of the problem and widespread support and follow up of surviving relatives." |
