Comprehensive statistical analysis of causes of death and histopathological diagnosis in medico-legal investigations of sudden cardiac deaths

Background and objectives. Sudden cardiac deaths (SCDs) have a significant impact worldwide. Its distribution trends may vary across different communities globally. Consequently, investigating sudden cardiac deaths necessitates a regional, multi-faceted approach. This study aims to ascertain the pathological background of the patients who died in the context of sudden cardiac death and analyze it statistically to generate some trends and define the occurrence of disease. Materials and methods. We conducted a retrospective analysis of the causes of death for cases from the Legal-Medicine Department of Maramures County, Romania, between 2021 and 2023. From this cohort, we identified and selected cases of SCD and conducted a statistical analysis of the number of cases, gender distribution, age group distribution, and the underlying cardiac pathology that led to this outcome. Results. 276 sudden cardiac deaths (SCD) were identified from 1,186 autopsies. Males accounted for 75% of SCD cases, with a mean age of 58.8 years. Advanced myocardial fibrosis (41.6%) was the most frequent cause, followed by coronary artery disease (18.12%) and acute myocardial infarction (17.4%). Males had significantly more AMI cases (p = 0.045), while females had more coronary artery disease and advanced myocardial fibrosis, though not statistically significant. Conclusions. Sudden cardiac death predominantly affects males, particularly those aged 51–60, with advanced myocardial fibrosis being the most common cause. The gender difference in AMI prevalence was significant, highlighting the need for targeted prevention and diagnostic improvements. Further research in liaison with experts in all fields is required.