Sudden Death as the Outcome of Cardiac Arrest, in a Portuguese Region: Where Do Resuscitation Manoeuvres Stand?

Cardiac Arrest (CA) is a major health problem, due to short and long-term sequelæ and to associated mortality. Despite the improvement of out-of-hospital and in-hospital resuscitation manoeuvres, unexpected sudden fatal events occur. The authors reported the features of a series of sudden death (SD) cases where cardiopulmonary resuscitation (CPR) was performed. Files of 1053 medico-legal autopsies, from victims aged ≥18 years-old, were reviewed. Cardiac Arrest leading to Sudden Death were found in 477 cases (45.3%), but only 199 (42%) of these had been submitted to resuscitation manoeuvres. There was an elderly male predominance. Both non-cardiac and cardiac CA/SD causes were present, despite the higher coronary artery disease incidence. Both out-of-hospital and in-hospital events took place. Age, severity of the disease, co-morbidities and predominance of out-of-hospital CA were obstacles to successful CPR, leading to SD. Knowing the population characteristics may help to improve Emergency Assistance.