TY - JOUR
T1 - Risk factors and causes of sudden noncardiac death
T2 - A nationwide cohort study in Denmark
AU - Risgaard, Bjarke
AU - Lynge, Thomas Hadberg
AU - Wissenberg, Mads
AU - Jabbari, Reza
AU - Glinge, Charlotte
AU - Gislason, Gunnar Hilmar
AU - Haunsø, Stig
AU - Winkel, Bo Gregers
AU - Tfelt-Hansen, Jacob
N1 - Copyright © 2015 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.
PY - 2015/5
Y1 - 2015/5
N2 - BACKGROUND: On the performance of an autopsy, sudden deaths may be divided into 2 classifications: (1) sudden cardiac deaths and (2) sudden noncardiac deaths (SNCDs). Families of SNCD victims should not be followed up as a means of searching for cardiac disease.OBJECTIVE: The purpose of this study was to report the risk factors and causes of SNCD.METHODS: We conducted a retrospective, nationwide study including all deaths between 2000 and 2006 of individuals aged 1-35 years and all deaths between 2007 and 2009 of individuals aged 1-49 years. Two physicians identified all sudden death cases through review of death certificates. Autopsy reports were collected. A multivariable logistic regression model was used to identify both clinical characteristics and risk factors associated with SNCD.RESULTS: We identified 1039 autopsied cases of sudden death, of which 286 (28%) were classified as SNCD. The median age in the SNCD death population was 32 years. Increasing age was inversely associated with SNCD (odds ratio [OR] 0.93, 95% confidence interval [CI] 0.87-0.98). Female sex, in-hospital location, and the absence of cardiac comorbidities were positively associated with SNCD (OR 1.7, 95% CI 1.3-2.3; OR 3.0, 95% CI 2.0-4.4; and OR 4.3, 95% CI 2.5-7.4, respectively). The most common cause of SNCD was pulmonary disease (n = 115 [40%]).CONCLUSION: Sudden death among individuals aged <50 years was caused by noncardiac diseases in 28% of cases. Risk factors were female sex, age, and the absence of cardiac comorbidities. These data may guide future strategies for the follow-up of family members of nonautopsied sudden death victims, improve risk stratification, and influence public health strategies.
AB - BACKGROUND: On the performance of an autopsy, sudden deaths may be divided into 2 classifications: (1) sudden cardiac deaths and (2) sudden noncardiac deaths (SNCDs). Families of SNCD victims should not be followed up as a means of searching for cardiac disease.OBJECTIVE: The purpose of this study was to report the risk factors and causes of SNCD.METHODS: We conducted a retrospective, nationwide study including all deaths between 2000 and 2006 of individuals aged 1-35 years and all deaths between 2007 and 2009 of individuals aged 1-49 years. Two physicians identified all sudden death cases through review of death certificates. Autopsy reports were collected. A multivariable logistic regression model was used to identify both clinical characteristics and risk factors associated with SNCD.RESULTS: We identified 1039 autopsied cases of sudden death, of which 286 (28%) were classified as SNCD. The median age in the SNCD death population was 32 years. Increasing age was inversely associated with SNCD (odds ratio [OR] 0.93, 95% confidence interval [CI] 0.87-0.98). Female sex, in-hospital location, and the absence of cardiac comorbidities were positively associated with SNCD (OR 1.7, 95% CI 1.3-2.3; OR 3.0, 95% CI 2.0-4.4; and OR 4.3, 95% CI 2.5-7.4, respectively). The most common cause of SNCD was pulmonary disease (n = 115 [40%]).CONCLUSION: Sudden death among individuals aged <50 years was caused by noncardiac diseases in 28% of cases. Risk factors were female sex, age, and the absence of cardiac comorbidities. These data may guide future strategies for the follow-up of family members of nonautopsied sudden death victims, improve risk stratification, and influence public health strategies.
U2 - 10.1016/j.hrthm.2015.01.024
DO - 10.1016/j.hrthm.2015.01.024
M3 - Journal article
C2 - 25614248
SN - 1547-5271
VL - 12
SP - 968
EP - 974
JO - Heart rhythm : the official journal of the Heart Rhythm Society
JF - Heart rhythm : the official journal of the Heart Rhythm Society
IS - 5
ER -