Key Points
- To identify the incidence, underlying causes, and clinical characteristics of sudden death in children and adolescents aged 1 to 20 years.
- Retrospective population-based review of all deaths occurring in individuals aged 1–20 years in one English health region between 1985 and 1994 (population = 806,500).
- Data gathered from death certificates supplied by the Office for National Statistics alongside medical records from coroners, paediatricians, physicians, and pathologists.
- Among 2,523 total deaths recorded, 1,017 (40%) were medical, 1,236 (49%) were unnatural, and 270 (11%) were categorized as sudden.
- Of the 270 sudden deaths, 142 (53%) had a prior diagnosis (epilepsy: 49 [34%], cardiovascular disease: 33 [23%], asthma: 30 [21%]); 87 were diagnosed post-mortem (respiratory infection: 32 [37%], unsuspected cardiovascular abnormalities: 26 [30%], other infections: 17 [20%]); and 41 remained unexplained.
- Undiagnosed hypertrophic cardiomyopathy caused <1 death per million person-years, whereas unexplained sudden death—potentially linked to primary cardiac arrhythmia—was approximately 10 times more frequent.
Structured PICO
PPopulation806,500 children and adolescents aged 1-20 years in one English health region (2,523 total deaths)
OOutcomeIncidence, causes, and characteristics of sudden deathhard clinical
Half of sudden deaths in children and adolescents are due to previously diagnosed conditions, while unexplained sudden deaths (likely primary arrhythmias) are about 10 times more common than undiagnosed hypertrophic cardiomyopathy.