Abstract P213: Sudden Death in Taiwan: Epidemiological Characteristics and Risk Factors
Background: Sudden death (SD) continues to be a great challenge for all physicians worldwide. The survival rate remains low even with significant advances in modern medicine. Defining the epidemiological characteristics and risk factors is essential for primary prevention of SD. We therefore verify these components of SD based on a prospective cardiovascular cohort in Taiwan.
Methods: The Chin-Shan Community Cardiovascular Cohort (CCCC) study is a population-based longitudinal cohort conducted since July, 1990 in a rural community northern of metropolitan Taipei. A total of 3,602 inhabitants (1,703 men and 1,899 women, 82.8% of targeted population) aged 35 years and older were included. Mortality was prospectively registered. SD was defined as unexpected non-traumatic death within 1 h of symptom onset or <24 h after the victim was last seen alive and stable in unwitnessed death. Baseline data upon inclusion were used for analysis, including age, gender, body mass index (BMI), cardiovascular risk factors, blood biochemical data and lipid profile. Univariate analysis was done first; the factors reaching statistical significance were then entered for multiple logistic regression analysis.
Results: From July 1, 1990 to Dec. 31, 2008, a total of 958 mortalities were ascertained. Eighty two (55 men and 27 women, 74.3±10.9 years old) of these died of SD, which constituted 8.5% of all mortality and 15.4% of all cardiovascular death. The age-standardized incidence rate was 117 per 100,000 person-years (male 163, female 71 per 100,000 person-years). The incidence appeared to be higher in winter, and there were two peaks in 24 h distribution (7 ~ 10 AM and 1 ~ 5 PM). Eighty five percent of SD occurred at home. The cause of death was acute coronary syndrome in 29%, while in 64% the etiology could not be defined due to lack of clinical information or autopsy. For risk factors, age, male, low BMI, hypertension, left or right ventricular hypertrophy, infarction pattern on ECG, and atrial premature complex served as independent risk factors for SD.
Conclusion: SD is more common than expected in the oriental societies. The risk factors are similar to those in western countries, though atrial premature complex on ECG may implicate specific pathogenic process in this population.