Current burden of sudden cardiac death: Multiple source surveillance versus retrospective death certificate-based review in a large US community
Current burden of sudden cardiac death: Multiple source surveillance versus retrospective death certificate-based review in a large US community
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DOI：
10.1016/j.jacc.2004.06.029
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发表时间：
2004-09-15
影响因子：
24
通讯作者：
McAnulty, J
中科院分区：
文献类型：
--
作者：
Chugh, SS;Jui, J;McAnulty, J
目的
我们试图采用前瞻性方法确定普通人群中心源性猝死（SCD）的年发病率。为评估回顾性监测的有效性，同时与基于死亡证明确定SCD发病率的方法进行了比较。
背景
对普通人群中SCD进行准确监测和特征描述可能会极大地促进当前及未来基于社区的预防和治疗干预措施。
方法
我们利用多种监测来源对俄勒冈州马尔特诺马县（人口660486）的所有居民进行了SCD的前瞻性评估。对死亡情况、医疗记录以及可获取的尸检数据进行了综合分析。并与使用国际疾病分类第10版编码和死亡地点基于死亡证明进行回顾性确定SCD发病率的方法进行了比较。
结果
在2002年2月1日至2003年1月31日期间，353名居民发生SCD（发病率为每10万人中53例；中位年龄69岁，57%为男性），占总死亡率的5.6%。其中，75例（21%）是通过急救人员以外的来源确定的。237例（67%）进行了复苏尝试，28例（8%）复苏成功（存活至出院）。基于死亡证明的回顾性审查得出1007例（发病率为每10万人中153例；中位年龄81岁，51%为男性），该方法的阳性预测值为19%。
结论
心源性猝死占年死亡率的5.6%，在普通人群中进行前瞻性评估似乎是可行的。使用多种确定和信息来源显著增强了SCD病例的表型分析。基于死亡证明的回顾性监测导致SCD发病率被显著高估。（C）2004年美国心脏病学会基金会
OBJECTIVES We sought to determine the annual incidence of sudden cardiac death (SCD) in the general population using a prospective approach. To assess the validity of retrospective surveillance, a simultaneous comparison was made with a death certificate-based method of determining SCD incidence.BACKGROUND Accurate surveillance and characterization of SCD in the general population is likely to significantly facilitate current and future community-based preventive and therapeutic interventions.METHODS We performed a prospective evaluation of SCD among all residents of Multnomah County, Oregon (population 660,486) using multiple sources of surveillance. A comprehensive analysis of circumstances of death, medical records, and available autopsy data was performed. Comparisons were made with a retrospective, death certificate-based determination of SCD incidence using International Classification of Diseases-Version 10 codes and location of death.RESULTS Between February 1, 2002, and January 31, 2003, 353 residents suffered SCD (incidence 53 of 100,000; median age 69 years, 57% male) accounting for 5.6% of overall mortality. Of these, 75 cases (21%) were identified using sources other than first responders. Resuscitation was attempted in 237 cases (67%) and successful (survival to hospital discharge) in 28 (8%). The retrospective death certificate-based review yielded 1,007 cases (incidence 153 of 100,000; median age 81 years, 51% male), and the positive predictive value of this methodology was 19%.CONCLUSIONS Sudden cardiac death accounts for 5.6% of annual mortality, and prospective evaluation in the general population appears to be feasible. The use of multiple sources of ascertainment and information significantly enhances phenotyping of SCD cases. Retrospective death certificate-based surveillance results in significant overestimation of SCD incidence. (C) 2004 by the American College of Cardiology Foundation.