台灣之突然非預期死亡之研究

An Investigation of the Sudden Unexpected Death in Taiwan

尹莘玲(Hsin-Ling Yin) ； 王崇儀(Chung-Yi Wang) ； 陳耀昌(Yao-Chang Chen) ； 方中民(John-Ming Fong)

《台灣法醫學誌》 1卷2期 (2009/12) Pp. 43-58

https://doi.org/10.6134/tjfm.2009.0102.02

摘要

目的：突然非預期性之死亡在司法上有法律之責任，在醫學上也有研究之義務。直至目前，台灣仍然沒有相關報告。
方法：本研究為回溯性研究，收集自民國八十七年五月至八十九年六月在屏東地方法院檢察署，和自八十九年七月至九十三年二月在高雄地方法院檢察署，由於突然非預期死亡而懷疑是非自然死亡，而接受司法死因調查和屍體解剖之案例。結果：共有180位案例符合，包括126位男性和54位女性。除1位為泰國籍勞工外，其餘皆為本國籍，並皆居住在屏東及高雄縣市，年齡由初出生至83歲。醫院發生為最常見發生死亡場所，共有99例(55.0%)，而心臟血管系統(25.0%)是最常受影響之器官系統，蜘蛛網膜下出血(15.6%)為最常見之單一致死疾病。
討論：由於各年齡層之突然非預期死亡的原因互有異同，趨向為隨著年齡由青壯至中老年期，原因亦由蜘蛛網膜下出血和急性消化胃腸道出血漸次轉為以心臟為主之疾病。蜘蛛網膜下出血和急性消化胃腸道出血之高比例反映出台灣民眾疾病之特別性。另外，感染為孩童和少年之突然非預期死亡的重要原因，不容忽視。

關鍵字

突然非預期死亡 ； 蜘蛛網膜下出血 ； 急性消化胃腸道出血 ； 感染 ； 急性心肌梗塞 ； 冠狀動脈疾病

並列摘要

Purpose: When death is sudden and unexpected, Judicial and medical field should intervene for elucidation for this type of death. However, there is no related data of sudden unexpected death in Taiwan.
Methods: A retrospective study was conducted to review the final results of the cases of sudden unexpected death in the southern Taiwan, which are the medicolegal autopsy cases from the Pingtung and Kaohsiung Local Court Prosecutor's Office between 1998 and 2004.
Results: A total of 180 cases were enrolled finally. They were 126 men and 54 women. All were residents in the Southern Taiwan, either Pingtung County, Kaohsiung City, or Kaohsiung County, except one case was foreigner from Thailand. Their age ranged from birth to 83 years. Hospital (55.0%) is the most common site of death scene, cardiovascular system (25.0%) was the first target, and subarachnoid hemorrhage (15.6%) was the leading single cause in this series. Conclusion: The causes of sudden unexpected death overlap but also differ among different age groups. From young, middle to old age, the importance of subarachnoid hemorrhage and upper gastrointestinal tract hemorrhage progressively shifted to cardiovascular diseases. A high frequency of subarachnoid hemorrhage and upper gastrointestinal tract hemorrhage in our series might reflect a specific disease pattern in Taiwan. In addition, infection, that was a major cause for death in children and young people, should not be neglected.

並列關鍵字

Sudden unexpected death ； Subarachnoid hemorrhage ； Upper gastrointestinal tract hemorrhage ； Infection ； Acute myocardial infarction ； Coronary artery disease

參考文獻

http://www.doh.gov.tw/statistic/data/衛生統計叢書2/94/下冊/目錄.htm

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