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Benefits and outcomes of a new multidisciplinary approach for the management and financing of sudden unexplained death cases in a forensic setting in Switzerland.
Neubauer, Jacqueline; Kissel, Christine K; Bolliger, Stephan A; Barbon, Daniela; Thali, Michael J; Kloiber, Daniel; Bode, Peter K; Kovacs, Boldizsar; Graf, Urs; Maspoli, Alessandro; Berger, Wolfgang; Saguner, Ardan M; Haas, Cordula.
Afiliação
  • Neubauer J; Zurich Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland.
  • Kissel CK; Department of Cardiology, University Heart Center, University Hospital Zurich, Zurich, Switzerland.
  • Bolliger SA; Zurich Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland.
  • Barbon D; Zurich Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland.
  • Thali MJ; Zurich Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland.
  • Kloiber D; Canton Zurich, Department of Justice, Bureau of Prosecution, Zurich, Switzerland.
  • Bode PK; Institute of Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland.
  • Kovacs B; Department of Cardiology, University Heart Center, University Hospital Zurich, Zurich, Switzerland.
  • Graf U; Institute of Medical Molecular Genetics, University of Zurich, Schlieren, Switzerland.
  • Maspoli A; Institute of Medical Molecular Genetics, University of Zurich, Schlieren, Switzerland.
  • Berger W; Institute of Medical Molecular Genetics, University of Zurich, Schlieren, Switzerland; Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland; Neuroscience Center Zurich, University and ETH Zurich, Zurich, Switzerland.
  • Saguner AM; Department of Cardiology, University Heart Center, University Hospital Zurich, Zurich, Switzerland.
  • Haas C; Zurich Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland. Electronic address: cordula.haas@irm.uzh.ch.
Forensic Sci Int ; 334: 111240, 2022 May.
Article em En | MEDLINE | ID: mdl-35276540
ABSTRACT
Sudden cardiac death (SCD) is an important public health issue. In young persons aged between 1 and 40 years, most SCDs are caused by potentially inherited cardiac diseases, often not detectable during conventional medico-legal investigations and therefore termed as sudden unexplained deaths (SUD). In this study, we describe the implementation, feasibility and importance of a standardized procedure to investigate SUD cases within the forensic framework at the Zurich Institute of Forensic Medicine in Switzerland. This new approach involves a multidisciplinary collaboration including forensic autopsy, second pathology expert opinion, post-mortem molecular genetic testing, cardiac counselling of relatives, and a tentative financing. This procedure is in line with the published Swiss and European recommendations on the management of SCDs. During a two-year pilot project, 39 sudden and unexpected death cases were collected, whereof 10 deceased remained without any identifiable cause of death after medico-legal investigation and second expert evaluation. Molecular autopsy, including 393 genes involved in cardio-vascular and metabolic diseases, identified eight pathogenic or likely pathogenic genetic variants in five out of the 10 deceased (50%). Cardio-genetic follow-up investigations in the families of the 10 deceased revealed phenotype-positive relatives in four families and required specific therapies, including an implantable cardioverter defibrillator (ICD) for primary prevention. Multidisciplinary collaboration is crucial for an optimal management of sudden unexplained death cases, to identify additional relatives at risk, and to prevent other tragic deaths within a family.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Testes Genéticos / Morte Súbita Cardíaca Tipo de estudo: Etiology_studies / Guideline / Health_economic_evaluation / Prognostic_studies Limite: Humans País/Região como assunto: Europa Idioma: En Revista: Forensic Sci Int Ano de publicação: 2022 Tipo de documento: Article País de afiliação: Suíça

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Testes Genéticos / Morte Súbita Cardíaca Tipo de estudo: Etiology_studies / Guideline / Health_economic_evaluation / Prognostic_studies Limite: Humans País/Região como assunto: Europa Idioma: En Revista: Forensic Sci Int Ano de publicação: 2022 Tipo de documento: Article País de afiliação: Suíça