• S Marelsson and G Thornorgeirsson.
• Department of Emergency and Intensive Care, Landspitali University Hospital, Fossvogi, 108 Reykjavík, Iceland. gesturth@landspitali.is.
• Laeknabladid. 2001 Dec 1; 87 (12): 973-8.

PurposeThe purpose of this investigation was to study specifically those cases of sudden death out-of-hospital in the Reykjavik area that were due to non-cardiac causes the last 13 years, from January 1987 to December 31, 1999.Material And MethodsThe doctors of the emergency ambulance have kept detailed files for all cases of sudden death according to international system of documentation, the Utstein protocol. The cases were divided into two major groups, i.e. on one hand cases due to outer causes and on the other hand cases due to inner causes. Outer causes included suicide, intoxication by drugs, trauma, drowning and cases due to asphyxia. Inner causes included various types of bleeding, hypoxia, cot death and various diseases other than heart disease.ResultsFrom 738 cases 140 or 19% were thought to be due to sudden non-cardiac death. Ninety-two cases of those 140 or 66% were due to outer causes. Inner causes were diagnosed in 48 (34%) cases. Mean age was 46 years (standard deviation, SD: 24.3 years). Men were 85 of the 140 cases (61%) and women 55 (39%). Mean response time was five minutes. Of the 140 individuals only nine (6%) survived, of those four had sustained near-drowning, four near suffocation and one drug intoxication.ConclusionsIn this study the data were reported in accordance with the Utstein protocol and therefore drug intoxication and suicide are not grouped together. However, most if not all cases of drug intoxication appear to have occurred in an attempt of suicide. Except for cardiac disease drug intoxication and suicides were together the most common causes of sudden death out-of-hospital in those instances attended by the crew of the emergency ambulance. The results of resuscitation attempts are much worse when the cause for sudden death is non-cardiac. Survival was relatively best in cases of "suffocation" or "drowning".

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