Citation

Karim S, Singh V, Tadikonda S, Pham HN, Chahal A, Ackerman MJ, Somers VK. J. Am. Coll. Cardiol. 2022; 79(Suppl): e1627.

Copyright

(Copyright © 2022, Elsevier Publishing)

DOI

10.1016/S0735-1097(22)02618-3

PMID

unavailable

Abstract

Background

The WHO defines sudden cardiac death as unexplained and non-violent, occurring within 1 hour of symptoms if witnessed or within 24 hours of being symptom free if unwitnessed. However, many deaths are sudden and unexpected, presumed to be cardiac, which may be due to other causes. The objective of this study was a contemporary reevaluation of sudden deaths in <18-years old residents of Olmstead County, MN, US.
Methods

The Mayo Clinic Sudden Death Registry was used to identify cases of sudden death in Olmstead County residents aged <18 years between Jan. 1960 and Dec. 2016. Multi-source ascertainment using death certificates, autopsy records, and case notes was performed. 4,749 Olmstead County residents were classified as non-violent, sudden death cases during the sampling timeframe.
Results

A total of 250 cases identified; 152 (60.8%) male. Most deaths, 176 (70.4%), occurred within the first year of life. Median age at death was 0.28 years (IQR 0.0 - 5.7 Years). Autopsy was performed in 215 (86.0%) cases and parentally refused in 3 (1.2%). 53 (21.2%) cases were classified as deaths due to cardiac causes of which; 25 (47.2%) were due to presumed arrhythmia or heart failure, 12 (22.6%) due to septal defects, 11 (20.8%) due to structural disease (6 tetralogy of Fallot, 5 transposition of the great arteries), and 5 (9.4%) due to valvular disease. 43 (17.2%) deaths were intrauterine, primarily due to placental pathology, followed by cord related deaths, 30 (12%) due to sudden infant death syndrome, 23 (9.2%) due to respiratory causes, primarily pneumonia, 17 (6.8%) due to marked prematurity, 17 (6.8%) due to neurological causes, primarily epilepsy, 15 (6.0%) due to unexpected drowning, 14 (5.6%) due to renal, gastrointestinal, endocrine or cancer related causes and 9 (3.6%) due to sepsis. 29 (11.6%) remained due to undetermined causes.
Conclusion

In this contemporary reevaluation, limited to residents of one county, served by one center performing all autopsies, and encompassing a 56-year period, sudden death in the young occurred most frequently in males and in the first year of life. Cardiac causes of death predominated, but include other causes such as neurological and pulmonary.