Incidence, characteristics and outcome of sudden cardiac death in France

Abstract

Purpose: Sudden Cardiac Death (SCD) is a major public health concern, but the actual epidemiology of SCD in Western European countries remains unclear. This study reports the results of a large registry to assess the incidence, prognostic factors, and outcomes of SCD in France. Methods: A population-based registry was established in May 2011 using multiple sources to collect every case of SCD in Paris and its suburbs, a population of 6.6 million. Both pre-hospital and in-hospital courses were considered, and the main outcome was survival at hospital discharge. Neurologic status at discharge was established. Results: Over one year, 1,903 cases of SCD were included. The annual incidence was 44/100,000 persons per year. Most cases occurred at home (72%) with bystanders in 81% of cases, performing CPR in 42% of cases. Initial rhythm was shockable in 23% of cases. 635 patients (33%) were admitted alive to hospital. Among hospitalized patients, 58% had coronary angiogram, and 58% had therapeutic hypothermia. Finally, 129 patients (6.8%) were discharged alive, of whom 94% had favorable neurological outcome. Prognostic factors were initial shockable rhythm (OR=15.7, 95%IC 9.0–27.3), age (OR=0.96, 95%IC 0.95–0.98), occurrence at home (OR=0.5, 95%IC 0.3–0.8), and epinephrine dose greater than 3 mg (OR=0.07, 95%IC 0.04–0.1). Among hospitalized patients, patients who received both therapeutic hypothermia and coronary angiogram had better survival (32% vs. 13%, P<0.001). ![Figure][1] Outcome of sudden cardiac death Conclusion: In France, incidence of SCD is lower than previously described, but prognosis remains poor. Prognostic factors are initial rhythm, age, occurrence at home, and epinephrine dose. Therapeutic hypothermia and early coronary angiogram are significantly associated with survival, but applied in only half of patients. [1]: pending:yes