Key result
Pediatric sudden cardiac death mortality fell ~1% annually from 2001 to 2020, with persistent demographic disparities.
Why the study?
Pediatric sudden cardiac death results from a wide spectrum of uncommon and heterogeneous conditions, and despite advancements in understanding and prevention strategies, national data on long-term mortality trends remain limited.
Observational (n=30,675)
Yes
Effect estimate: APC -1.0% (95% CI -1.2 to -0.8)
Absolute Event Rate: 2% vs 2.8%
p-value: p=<=0.05
Although U.S. pediatric sudden cardiac death mortality declined by approximately 29% between 1999 and 2020, substantial sociodemographic and regional disparities persist, with consistently higher mortality rates in males, non-Hispanic Black children, and specific states like Mississippi.
Declining pediatric SCD mortality supports prevention efforts; leaves open targeted strategies to address persistent disparities.
Introduction Sudden cardiac death (SCD) in children is rare but devastating, often affecting previously healthy children. Unlike adults, pediatric SCD results from a wide spectrum of uncommon and heterogeneous conditions. Despite recent advancements in understanding and prevention strategies, national data on long-term mortality trends remain limited. Material and methods We analyzed death certificate data from the CDC WONDER database from 1999 to 2020 for SCD-related mortality in individuals aged 0 to 14 years. Age-adjusted mortality rates (AAMRs) per 100,000, with 95% confidence intervals (CIs) and annual percentage changes (APCs) with 95% CIs, were calculated, stratified by year, sex, race, state, urbanization, and census region. Results From 1999 until 2020, 30,675 pediatric SCD-related deaths occurred. The AAMR declined from 2.8 per 100,000 population in 1999 to 2.5 (APC = –6.0%, 95% CI: –10.8 to –0.9) in 2001 and further to 2.0 in 2020 (APC = –1.0%, 95% CI: –1.2 to –0.8). AAMRs were consistently higher in males than in females (1999: 3.2 vs. 2.4; 2020: 2.1 vs. 2.0). When stratified by race, non-Hispanic (NH) Black children had the highest AAMRs. Rates declined in all U.S. regions, with the highest rates observed in the Northeast (3.5 to 1.9) and the lowest in the Midwest (1.7 to 1.2). State-level rate disparities were marked, ranging from 4.9 in Mississippi to as low as 1.1 in Maine, Maryland, and Wisconsin. Conclusions Despite overall declines in SCD-related mortality, significant disparities persist across sex, race, region, and urbanization.
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Khan et al. (2026) conducted an observational in Pediatric sudden cardiac death (n=30,675). Calendar period (2001 to 2020 vs 1999) vs. Baseline year (1999) was evaluated on Age-adjusted mortality rate (AAMR) per 100,000 population for pediatric sudden cardiac death (APC -1.0%, 95% CI -1.2 to -0.8, p=<=0.05). Pediatric sudden cardiac death-related age-adjusted mortality declined from 2.8 per 100,000 in 1999 to 2.0 in 2020 (APC -1.0% from 2001-2020), though sex, racial, and geographic disparities persisted.
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