Sudden Cardiac Death Decreasing: Why Remains Unclear.

Abstract

* Abbreviations: CA — : cardiac arrest CHD — : congenital heart disease CPR — : cardiopulmonary resuscitation IH — : in-hospital OH — : out-of-hospital SCD — : sudden cardiac death The article by El-Assaad et al1 describes death certificate data from children (excluding infants 0–12 months old) and young adults (<35 years old) who died from sudden cardiac death (SCD) outside a hospital setting. The authors report that annual rates of SCD in young children (1–10 years old) remained steady, whereas rates of SCD among older children, teenagers, and young adults fell significantly over the study years. Additionally, African Americans had consistently higher annual rates of SCD compared with other racial and ethnic groups, but they also experienced the greatest improvement over the 15 study years ending in 2015. Of note, the composition of underlying cardiac conditions associated with SCD varied across age groups, with congenital heart disease (CHD) and arrhythmia being the most common in young children, whereas ischemic heart disease and arrhythmia were the most prevalent in young adults. However, autopsies were performed in less than one-third of the deaths,1 and physician coding for death certificates is known to vary widely.2 Likewise, the authors did not detail how cases with multiple International Classification of Diseases, … Address correspondence to Susan L. Bratton, MD, MPH, Division of Pediatric Critical Care, University of Utah Pediatrics, 295 Chipeta Way, PO Box 581289, Salt Lake City, UT 84113. E-mail: susan.bratton{at}hsc.utah.edu