Abstract P601: Death Certificate-Based Screening Methodology is an Efficient and Accurate Methodology for Identifying Sudden Death Victims

Abstract

Introduction: Out-of-hospital sudden death accounts for over 10% of all deaths among working age adults. Traditional methods of identifying victims by screening Emergency Medical Services (EMS) reports and clinical adjudication are labor intensive. We hypothesize death certificates may provide efficient and reliable information to identify victims of sudden death. This study aims to compare a death certificate-based sudden death screening algorithm to a more time-intensive EMS-screened and cardiologist-adjudicated sudden death method. Methods: Death certificates from four North Carolina counties (Guilford, Mecklenburg, Surry, Wake) were screened by written protocol. Cases were excluded if age under 18 or over 64, hospital death, non-free living, or non-natural cause of death (overdose, gunshot wound, suicide, drowning, cancer, traumatic death without evidence of coronary disease). Census tract data was determined from victim home address. These 2013 death certificate cases were compared to our preexisting dataset of EMS-screened, cardiologist-adjudicated cases identified in Wake County 2013-2015. Demographic data was compared between datasets using Wilcoxon rank sum test for continuous variables and Fisher’s exact test for categorical variables. Results: Death certificate cases included 518 victims and EMS-screened/cardiologist-adjudicated cases included 399 victims. There were 99 overlapping cases in both datasets which were excluded from this comparative analysis. Demographic and social data were similar in the two groups (Table 1). Conclusion: Like previous methods have shown, sudden death occurs predominantly among unmarried individuals and is more common among black race and male sex. Death certificate screening methods are sufficient to identify sudden death victims to allow for efficient, population-based assessment of the epidemiology of sudden death. These methods may allow for identification of high-risk communities to facilitate intervention to reduce the incidence of sudden death.