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Clinical Investigations in Critical Care |

Clinical Characteristics of Unexpected Death Among Young Enlisted Military Personnel*: Results of a Three-Decade Retrospective Surveillance

Howard Amital, MD, MHA; Michael Glikson, MD; Moshe Burstein, MD, MHA; Arnon Afek, MD, MHA; Ronit Sinnreich, PhD; Yuval Weiss, MD, MPH; Vered Israeli, MD, MHA
Author and Funding Information

*From the Israeli Defense Forces-Medical Corps (Drs. Amital, Burstein, Afek, Weiss, and Israeli), Israeli Defense Forces, Jerusalem, Israel; Electrophysiology Unit (Dr. Glikson), Heart Institute, Sheba Medical Center and Tel Aviv University, Tel-Hashomer, Israel; and the Epidemiology Unit (Dr. Sinnreich), Hadassah Medical Center, Hebrew University, Jerusalem, Israel.

Correspondence to: Howard Amital, MD, MHA, Rheumatology Unit, Hadassah University Hospital, Ein–Kerem, PO box 12000, Jerusalem 91120, Israel; e-mail: amitalh@hadassah.org.il



Chest. 2004;126(2):528-533. doi:10.1378/chest.126.2.528
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Study objective: To explore the causes of sudden and unexpected death in a young and healthy military population, to examine the various patterns of diseases associated with these tragic events, and to investigate the factors found to be associated with this grave outcome.

Design: We retrospectively investigated 151 cases of Israeli military personnel who died unexpectedly over a 30-year period. We collected all the available medical records, autopsy results, and investigation committee reports.

Results: A total of 151 cases of sudden and unexpected death occurred among enlisted military personnel during the period. Cardiac disorders caused 47% of deaths, followed by neurologic causes (17%) and pulmonary causes (11%). In 30 events (20%), the cause of death remained undetermined. Symptoms (eg, syncope, chest pain, palpitations, and others) occurred prior to death in 52 cases (34%). Asthma was the most common risk factor in our study population having been previously recognized in 10 cases (6.7%). Eight of the 13 subjects with asthma died following an acute asthmatic attack.

Conclusion: Cardiac events are the leading cause of unexpected death in young healthy people. The frequency of subjects with asthma was found to be higher than that in the general age-adjusted population.

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