Abstract

Background: Sudden pathological death is an important category of natural death in forensic practice, as it often occurs suddenly and unexpectedly, frequently outside healthcare facilities, with limited clinical information before death, and requires forensic examination to determine the cause of death. Materials and Methods: This was a retrospective cross-sectional descriptive study of 120 cases of sudden pathological death undergoing forensic examination at the Forensic Medicine Center of Ho Chi Minh City from January 2025 to June 2025. Data were collected from forensic records, histopathological slides, and corresponding paraffin blocks. The analyzed variables included sex, age group, body habitus, presence of witnesses, hospitalization status, activity before death, time of death discovery, causes of death by organ system, and characteristics of the sudden cardiovascular death group. Results: Among the 120 cases, most were male (77.5%), over 40 years of age (75.8%), of average body habitus (55.8%), unwitnessed (56.7%), and died before hospital admission (90.0%). Cardiovascular diseases were the leading cause, accounting for 60.0% of cases, followed by respiratory diseases (19.2%), neurological diseases (14.2%), gastrointestinal diseases (2.5%), and other causes (4.1%). In the cardiovascular group, myocardial infarction/coronary atherosclerosis accounted for the highest proportion, at 87.5%. Compared with the non-cardiovascular group, the cardiovascular group had a higher proportion of witnessed deaths, 51.4% versus 31.3%, p = 0.029; and a higher proportion of deaths before hospital admission, 94.4% versus 83.3%, p = 0.047. Conclusion: Cardiovascular diseases were the most common cause of sudden pathological death among forensic cases. Myocardial infarction/coronary atherosclerosis accounted for a high proportion of cardiovascular causes. This study provides preliminary data on the causes and forensic epidemiological characteristics of sudden natural death in Ho Chi Minh City; however, further studies with longer study periods and larger sample sizes are needed.