Abstract 18896: Preliminary Analysis of the National Child Death Review Database for Cardiovascular Deaths

Abstract

Background: The National Center for the Review and Prevention of Child Deaths (NCRPCD) maintains a unique multistate database supported by the US Maternal and Child Health Bureau to record circumstances of child deaths with data submitted by state Child Death Review teams. Methods: We aim to describe circumstances of child cardiovascular deaths (CVD) in the NCRPCD database and to identify modifiable risk factors, potential disparities, and their contribution to sudden cardiac death (SCD) and non-sudden CVD. An analytical dataset involving 16 states was developed for analysis of CVD cases occurring in 2005-2009. We developed algorithms to identify SCD and non-sudden CVD cases. Logistic regression was used to identify correlates of SCD among all CVD cases. Results: CVD cases (1099) were 0.6 (0.1, 9.6) yrs median (IQR) with 55% ≤1 yr and 22% ≥12 yrs; Male 58%; White 70%, Black 22%, Asian 2%, Other 5%; Hispanic ethnicity 19%. Prior conditions, present in 47%, included congenital heart defects (CHD), 23%; cardiomyopathy (CM), 4%; arrhythmia (AR), 2%. Most deaths occurred at home/school, 30% or in the hospital, 40%. Common causes of death were CHD 21%; AR 17%; and CM 8%. Reclassification indicated 59.1% (649/1099) of CVD were SCD and 33.8% (371/1099) were non-sudden CVD. Differences in SCD (versus non-sudden death) were noted by race with SCD in 73.2% blacks vs. 60.9% whites (p=0.02). More SCD occurred in the suburban (84.9%) than in urban sites (57.6%) p<0.0005. Among SCD, 911 was called in 92.6% of suburban and 78.6% of urban SCD (p=0.006). In a multivariable logistic regression model (Table) being black, older (>6 months), Hispanic, and living in the suburbs were significantly associated with SCD. Conclusions: The NCRPCD database contains valuable information to help understand and prevent SCD. Evaluation of risk factors for SCD indicated a higher risk by race, age, ethnicity, and location.