Author + information
- Received May 7, 2004
- Revision received June 2, 2004
- Accepted June 7, 2004
- Published online September 15, 2004.
- Sumeet S. Chugh, MD, FACC*,* (, )
- Jonathan Jui, MD*,
- Karen Gunson, MD*,
- Eric C. Stecker, MD*,
- Benjamin T. John, MD*,
- Barbara Thompson, BSN, JD*,
- Nasreen Ilias, BS*,
- Catherine Vickers, RN*,
- Vivek Dogra, MD*,
- Mohamud Daya, MD*,
- Jack Kron, MD, FACC*,
- Zhi-Jie Zheng, MD, PhD†,
- George Mensah, MD, FACC† and
- John McAnulty, MD, FACC*
- ↵*Reprint requests and correspondence:
Dr. Sumeet S. Chugh, Cardiology Division, UHN-62, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Portland, Oregon 97239
Objectives We sought to determine the annual incidence of sudden cardiac death (SCD) in the general population using a prospective approach. To assess the validity of retrospective surveillance, a simultaneous comparison was made with a death certificate-based method of determining SCD incidence.
Background Accurate surveillance and characterization of SCD in the general population is likely to significantly facilitate current and future community-based preventive and therapeutic interventions.
Methods We performed a prospective evaluation of SCD among all residents of Multnomah County, Oregon (population 660,486) using multiple sources of surveillance. A comprehensive analysis of circumstances of death, medical records, and available autopsy data was performed. Comparisons were made with a retrospective, death certificate-based determination of SCD incidence using International Classification of Diseases-Version 10 codes and location of death.
Results Between February 1, 2002, and January 31, 2003, 353 residents suffered SCD (incidence 53 of 100,000; median age 69 years, 57% male) accounting for 5.6% of overall mortality. Of these, 75 cases (21%) were identified using sources other than first responders. Resuscitation was attempted in 237 cases (67%) and successful (survival to hospital discharge) in 28 (8%). The retrospective death certificate-based review yielded 1,007 cases (incidence 153 of 100,000; median age 81 years, 51% male), and the positive predictive value of this methodology was 19%.
Conclusions Sudden cardiac death accounts for 5.6% of annual mortality, and prospective evaluation in the general population appears to be feasible. The use of multiple sources of ascertainment and information significantly enhances phenotyping of SCD cases. Retrospective death certificate-based surveillance results in significant overestimation of SCD incidence.
Dr. Chugh is supported by U.S. Centers for Disease Control and Prevention/Association of Teachers of Preventive Medicine Grant TS-0660 and the Doris Duke Foundation Innovation in Clinical Research Award. Drs. Stecker and John are recipients of post-doctoral fellowship awards from the American Heart Association.
- Received May 7, 2004.
- Revision received June 2, 2004.
- Accepted June 7, 2004.
- American College of Cardiology Foundation