Acute cardiac care & resuscitation
Prospective Countywide Surveillance and Autopsy Characterization of Sudden Cardiac Death: POST Sudden Cardiac Death (SCD) Study
Authors' conclusion
Forty percent of deaths attributed to stated cardiac arrest were not sudden or unexpected, and nearly half of presumed SCDs were not arrhythmic.
Study context
- Population
- All incident out-of-hospital cardiac arrest deaths, aged 18 to 90 years, San Francisco County, February 2011–March 2014541 met World Health Organization (WHO) SCD criteria
- Participants
- 912 participants
- Outcome
- Incidence and autopsy-defined causes of SCD (autopsy-defined sudden arrhythmic death)
Methodological detailsmedical examiner-based surveillance, countywide, 525 (97%) of WHO-defined SCDs autopsied, Multidisciplinary committee adjudicated final cause
- Medical examiner-based surveillance
- Countywide
- 525 (97%) of WHO-defined SCDs autopsied
- Multidisciplinary committee adjudicated final cause
Main finding
As reported in the abstract
- Countywide WHO-defined SCD incidence (highest in black men, P<0.0001)
- 29.6/100 000 person-years
- OHCA deaths meeting WHO SCD criteria
- 541 (59%)
- Autopsy-defined sudden arrhythmic deaths, overall
- 55.8% (293/525)
- Autopsy-defined sudden arrhythmic deaths, witnessed
- 65% (78/120)
- Autopsy-defined sudden arrhythmic deaths, unwitnessed (witnessed vs unwitnessed P=0.024)
- 53% (215/405)
Observational data: associations, not effects.
Further findings
Leading causes of death among WHO-defined SCDs
- Coronary disease
- 32%
- Occult overdose
- 13.5%
- Cardiomyopathy
- 10%
- Cardiac hypertrophy
- 8%
- Neurological
- 5.5%
No cardiac history among WHO-defined SCDs
- No cardiac history
- 301 (57%)
Structural cardiac disease among autopsy-defined sudden arrhythmic deaths
- Structural cardiac disease
- 286 of 293 (98%)
Original publication
Prospective Countywide Surveillance and Autopsy Characterization of Sudden Cardiac Death: POST SCD Study. Circulation. Published 19 June 2018. doi:10.
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