Analysis of Causes of Sudden Death Among Russian Railway Workers

INTRODUCTION: Health protection of railway workers of various professional groups increases the safety of railway transport, the prestige of the profession and reduces morbidity and mortality from the most common causes in this group of patients. 
AIM: To analyze the risk factors of sudden death among Russian Railways workers. 
MATERIALS AND METHODS: The design of the study is made according to the case-control type. Analysis was carried out of all cases of sudden death (SD) of employees of JSCo Russian Railways (RR) in the period from 2009 to 2021 (n = 412). The comparison group consisted of 411 employees of RR who were undergoing periodical medical examination. The groups were formed on the basis of age, employment period, gender, profession. To assess the diagnostic significance of the quantitative signs in predicting a certain outcome, the method of analysis of ROC curves was used. 
RESULTS: The chances of death for workers of RR increased in case of past myocardial infarction, and also depended on the type of intervention (p 0.001). The threshold value of the BMI index in the cut-off point, which corresponded to the highest value of Youden index, was 27.1 kg/m2. In the group of sudden deaths, there were 1.8 times more smokers and 2 times less individuals with total cholesterol level exceeding 5 mmol/l than in the comparison group (p 0.001). A prognostic model was developed by ROC-analysis to determine the probability of mortality. The sensitivity and specificity of the model were 79.5% and 91.9%, respectively. 
CONCLUSION: A prognostic model was developed to determine the probability of sudden death in Russian railway workers, with the sensitivity and specificity 79.5% and 91.9%, respectively. However, the present study did not permit to reveal predictors of sudden death specific of the workers of RR.