Sudden Death

Sudden death involves the unexpected or untimely death of an individual. The term is commonly used to refer to sudden cardiac death—a natural death from cardiac causes, heralded by an abrupt loss of consciousness within one hour of the onset of acute symptoms. Other forms of sudden death may be noncardiac in origin. Examples include respiratory arrest, toxicity or poisoning, anaphylaxis, or trauma.

The sudden cardiac death concept incorporates the features of natural, rapid, and the unexpected. It does not specifically refer to the mechanism or cause of death. Common examples of unexpected natural deaths include deaths by heart attack, stroke, or ruptured aneurysm, death from rapidly progressive infectious diseases, sudden infant death syndrome, postoperative complications, pregnancy and postpartum, and natural disasters, including earthquakes, hurricanes, and floods.

Some sudden losses are the result of intentional acts, such as suicide and homicide. Also, deaths from bombings and acts of war and terrorism are intentional acts, although direct contact with the intended victims is not always present. Other deaths, such as vehicular homicide due to reckless or drunken driving, have a lesser degree of intentionality. The individual responsible for the death made a choice that resulted in another's death, but there was no premeditation. Finally, in the case of sudden death as a result of accident, there is no clear intentionality.

Some sudden losses may have a degree of expectedness. For example, the heart attack of someone at risk or the sudden loss of someone struggling with a life-threatening illness, even supposedly in recovery, may not be completely unexpected. Suicide is commonly described as a form of sudden, unexpected death. This view evolves from suicide survivors who report that they often feel unprepared and describe the event as a devastating emotional blow. Although suicide is sudden, the death is not always unexpected. This is because the decision to take one's life is frequently preceded by depression and psychiatric disturbances, the occurrence of diverse negative stressful events, and suicide warnings, threats, and/or attempts. Most individuals who commit suicide provide cues about their intention, and many suicide survivors recognize this to be the case.

Incidence of Sudden Death and Survivorship

The major forms of sudden death rank among the major leading causes of death in the United States today. In 2005, heart disease was the leading cause of death. Cerebrovascular diseases, including strokes, were the 3rd leading cause of death, while accidental death ranked 5th, suicide was 11th, and homicide ranked 15th among the leading causes of death.

The impact of sudden death on the lives of survivors is widespread. With nearly 1 million sudden deaths each year, researchers estimate that each sudden death affects 3 family members on average and 7 to 10 close relatives and other significant others. Based on these estimates, sudden death impacts 10 to 12 million survivors annually in the United States.

The Aftereffects of Sudden Loss

The suddenness of death can raise a number of complex issues for survivors. Research findings suggest that sudden death leads to more immediate and long-term coping problems among the surviving family members than deaths that are anticipated. Indeed, sudden death has been associated with frequent and persistent depressive syndromes, the onset of new illnesses or the exacerbation of existing illnesses, and increases in health-compromising behaviors, such as alcohol consumption and prescription drug use. Although survivors of sudden loss share many of the same general bereavement reactions as those of anticipated deaths, shock and denial are commonly associated with sudden death bereavement.

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