Unexpected sudden death due to recreational swimming and diving in men in Croatia in a 14-year period [Iznenadna smrt tijekom rekreacijskog plivanja i ronjenja u muškaraca u Hrvatskoj u 14-godišnjem razdoblju]

Duraković, Zijad and Mišigoj Duraković, Marjeta and Škavić, Josip and Definis Gojanović, Marija (2012) Unexpected sudden death due to recreational swimming and diving in men in Croatia in a 14-year period [Iznenadna smrt tijekom rekreacijskog plivanja i ronjenja u muškaraca u Hrvatskoj u 14-godišnjem razdoblju]. Collegium Antropologicum, 36 (2). pp. 641-645. ISSN 0350-6134

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Abstract

The article deals with 17 sudden deaths which occurred during recreational swimming and diving in men in Croatia in a 14-year period: from January 1, 1998 to December 31, 2011. The sample is taken out from the total number of 61 sudden deaths in men during or immediately after sport or recreational exercise. Included are also sudden deaths of 8 foreigners spending holidays at the Croatian Adriatic Coast. In all of them forensic medicine autopsy was done. Thirteen males from Croatia died during recreational swimming. Three of them were aged 15-29 yrs: one had signs of hypertrophic cardiomyopathy, the second suffered from chronic myopericarditis with left ventricular aneurysm, and the third had cardiomegaly and blood alcohol level of 1.7 per thousand. Five were aged 30-64 yrs: four of them have suffered from coronary atherosclerosis and left ventricular hypertrophy of 15-18-18-22 mm, and one with left ventricular hypertrophy drowned suddenly, probably because of malignant ventricular arrhythmia. The fifth suffered stroke and drowned. Five elderly men, aged 65-85 yrs, have suffered from coronary atherosclerosis, myocardial fibrosis or myocardial scars, and three of them had left ventricular hypertrophy of 19 mm. Four males died during recreational diving. One aged 26yrs drowned, at autopsy he had left ventricular hypertrophy of 17 mm. Three males were middle-aged: two had coronary atherosclerosis, two of them had a severe degree of coronary atherosclerosis and one had coronary atherosclerosis of medium degree but with myocardial fibrosis and left ventricular hypertrophy of 18 mm. Seven male foreigners died, five of them during swimming: two aged 30-64 and two aged 65-85. They all have had coronary atherosclerosis: one of them had an acute myocardial infarction of the posterior wall, and one hypertrophic cardiomyopathy as well. One middle-aged and one elderly man died during diving, and both had an acute myocardial infarction of the posterior wall. One elderly foreign woman died during swimming, she had coronary atherosclerosis and a myocardial scar. In Croatia, death rate during both swimming and diving in men aged 15-29 years amounted to 0.63/1,000.000 (p=1.0000); in those aged 30-64 it reached 0.56/1,000.000 (p=0.3698), and in those aged 65-85 it was 1.41/1,000.000 (p=0.1849). The death rate during swimming in men aged 15-29 amounted to 1.47/1,000.000 (p=0.9864), in men aged 30-64 it reached 0.35/1,000.000 (p=0.2245), and in those aged 65-85 it was 1.41/1,000.000 (the difference is significant, p=0.0472). The death rate during diving in men aged 15-29 was 0.16/1,000.000, and in men aged 30-64 the observed rate was 0.21/1,000.000 (p=1.0000).

Abstract in Croatian

U članku je izneseno 17 naglih smrti u muškaraca za vrijeme rekreacijskog plivanja ili ronjena u Hrvatskoj u vremenu od 14 godina: od 1. siječnja 1998. do 31. prosinca 2011 g., od ukupno 61 muškarca preminulog za vrijeme ili neposredno nakon tjelovježbe, i u 7 muškaraca stranaca i jedne strankinje. U svih je provedena sudsko-medicinska obdukcija. Za vrijeme rekreacijskog plivanja u Hrvatskoj naglo je umrlo 13 muškaraca. Trojica su bili u dobi 15–29 g.: jedan je imao hipertrofijsku kardiomiopatiju, drugi kronični mioperikarditis s aneurizmom lijeve klijetke, treći kardiomegaliju s koncentracijom etanola u krvi od 1.7‰. Petorica su bila su dobi 30–64 g.: četvorica su imala koronarnu aterosklerozu i hipertrofiju lijeve klijetke 15–18–18–22 mm, a jedan od njih naglo se utopio, vjerojatno zbog maligne aritmije klijetki, dok se drugi utopio zbog razvoja apopleksije mozga. Pet ih je bilo tzv. starije dobi: 65–85 g., a imali su koronarnu aterosklerozu, fibrozu miokarda, ožiljke nakon preboljelog infarkta miokarda, a trojica su imala hipertrofiju lijeve klijetke od 19 mm. Četvorica su umrla za vrijeme rekreacijskog ronjenja. Jedan u dobi od 26 g. imao je hipertrofiju lijeve klijetke od 17 mm, dok su trojica dobi 30–64 g. imali koronarnu aterosklerozu, jedan fibrozu miokarda i hipertrofiju lijeve klijetke od 18 mm. Sedam je stranaca umrlo, od toga petorica za vrijeme plivanja. Trojica su bila u dobi 30–64 g. a dvojica u dobi 65–85 g., od čega su četvorica imala koronarnu aterosklerozu, jedan akutni infarkt miokarda stražnje stjenke lijeve klijetke, a jedan hipertrofijsku kardiomiopatiju. Dvojica su umrla za vrijeme ronjenja: oba su imala akutni infarkt miokarda stražnje stjenke lijeve klijetke. Jedna žena starije dobi umrla je za vrijeme plivanja, imala je koronarnu aterosklerozu i ožiljak nakon preboljelog infarkta miokarda. Stopa smrti za vrijeme rekreacijskog plivanja ili ronjenja, u 14-godišnjem razdoblju u Hrvatskoj u muškaraca dobi 15–29 g. iznosi 0,63/1.000.000 (p=1,0000); u muškaraca dobi 30–64 g. iznosi 0,56/1.000.000 (p=0,3698) i u onih dobi 65–85 g. iznosi 1,41/1.000.000 (p=0,1849). Stopa smrti za vrijeme rekreacijskog plivanja u muškaraca dobi 15–29 g. iznosi 0,47/1.000.000 (p=0,9864), u muškaraca dobi 30–64 g. iznosi 0,35/ 1.000.000 (p=0,2245), a u dobi 65–85 g. iznosi 1,41/1.000.000 (razlika je značajna: p=0,0472). Stopa smrti za vrijeme ronjenja u muškaraca dobi 15–29 g. iznosi 0,16/1.000.000, a u muškaraca dobi 30–64 g. 0,21/ 1.000.000 (p=1,0000).

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