Incidence of Sudden Cardiac Death in a Young Active Population
Incidence of Sudden Cardiac Death in a Young Active Population
复制标题
DOI：
10.1161/jaha.115.001818
复制
发表时间：
2015-06-01
影响因子：
5.4
通讯作者：
Kales, Stefanos N.
中科院分区：
文献类型：
--
作者：
Farioli, Andrea;Christophi, Costas A.;Kales, Stefanos N.
背景-关于在活跃的假定健康人群中心脏性猝死（SCD）的负担知之甚少。我们调查了美国男性职业firefighters.Methods和结果之间的美国男性职业firefighters. Methods和2012年所有值班SCD的发病率，从美国消防局和美国国家职业安全与健康研究所的数据库中确定。计算了SCD的动脉特异性发病率（IR）及其95% CI。一个联合点模型被用来分析IR的趋势，并帮助估计多年来SCD率的年度百分比变化。季节性的影响进行了评估，通过泊松回归模型。我们确定了182例SCD;基于99份可用的尸检报告，主要潜在死亡原因是冠心病（79%）。总体IR为18.1 SCD/100 000人-年。SCD的年龄特异性IR范围为3.8（18至24岁）至45.2（55至64岁）/100 000人-年。SCD的年发生率随时间稳步下降（年百分比变化-3.9%，95%CI-5.8至-2.0）。SCD事件在1月份更频繁（峰低比1.70; 95% CI 1.09 - 2.65）。此外，高风险工作期间的IR是低风险工作期间的3倍。消防员之间的IR低于美国一般人群和美国军事人员中观察到的。结论-SCD风险在这活跃的工作人群被高估，使用统计数据从一般人群。为了解决这些亚群中的公共卫生问题，应该对活跃的成年人进行更具体的研究。
Background-Little is known about the burden of sudden cardiac death (SCD) among active, presumably healthy persons. We investigated the incidence of SCD among US male career firefighters.Methods and Results-All on-duty SCDs among US male career firefighters between 1998 and 2012 were identified from the US Fire Administration and the US National Institute for Occupational Safety and Health databases. Age-specific incidence rates (IRs) of SCD with 95% CIs were computed. A joinpoint model was fitted to analyze the trend in IR and to help estimate the annual percentage change of SCD rates over the years. The effects of seasonality were assessed through a Poisson regression model. We identified 182 SCDs; based on 99 available autopsy reports, the leading underlying cause of death was coronary heart disease (79%). The overall IR was 18.1 SCDs per 100 000 person-years. The age-specific IRs of SCD ranged between 3.8 (for those aged 18 to 24 years) and 45.2 (for those aged 55 to 64 years) per 100 000 person-years. The annual rate of SCD steadily declined over time (annual percentage change -3.9%, 95% CI -5.8 to -2.0). SCD events were more frequent during January (peak-to-low ratio 1.70; 95% CI 1.09 to 2.65). In addition, the IR was 3 times higher during high-risk duties compared with low-risk duties. IRs among firefighters were lower than those observed among the US general population and US military personnel.Conclusions-SCD risk in this active working population is overestimated using statistics from the general population. To address public health questions among these subpopulations, more specific studies of active adults should be conducted.