Current burden of sudden cardiac death: Multiple source surveillance versus retrospective death certificate-based review in a large U.S. community
Key result
Retrospective death certificates overestimate sudden cardiac death incidence, yielding only ~19% positive predictive value.
- n=660,486
Authors
Discussion
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Implication
Prospective surveillance reveals a sudden cardiac death incidence of 53 per 100,000, indicating that retrospective death certificate reviews substantially overestimate mortality burden.
Key Points
- To determine the annual incidence of sudden cardiac death in the general population using prospective multi-source surveillance and assess the validity of retrospective death certificate reviews.
- Conducted a 1-year prospective surveillance study of sudden cardiac death among all residents of Multnomah County, Oregon (population 660,486) between February 1, 2002, and January 31, 2003, analyzing emergency response data, medical records, and autopsies.
- Evaluated retrospective surveillance by identifying cases through International Classification of Diseases-10 codes and location of death on official death certificates.
- Prospective surveillance identified 353 sudden cardiac deaths (annual incidence 53 per 100,000; median age 69 years; 57% male), accounting for 5.6% of overall community mortality.
- Resuscitation was attempted in 237 prospective cases (67%) and was successful (survival to hospital discharge) in 28 cases (8%).
- Retrospective death certificate analysis identified 1,007 cases (incidence 153 per 100,000; median age 81 years; 51% male), demonstrating a positive predictive value of only 19%.
Study Design
Type
Observational (n=660,486)
Multicenter
No
PICO
P
Population
660,486 residents of Multnomah County, Oregon evaluated for sudden cardiac death over a 1-year period to compare prospective surveillance with retrospective death certificate review.
E
Exposure / Comparator
Multiple source prospective surveillance vs Retrospective death certificate-based review
O
Primary Outcome
Annual incidence of sudden cardiac death per 100,000
Main Result
Absolute Event Rate: 53% vs 153%
Cite This Study
Chugh et al. (2004) conducted an observational in Sudden cardiac death (n=660,486). Multiple source prospective surveillance vs. Retrospective death certificate-based review was evaluated on Annual incidence of sudden cardiac death per 100,000. Prospective surveillance found an annual sudden cardiac death incidence of 53 per 100,000; retrospective death certificate review overestimated it at 153 per 100,000 (positive predictive value 19%).