Abstract 146: Incidence, Causes and Outcome of Sudden Death in Children: A Comprehensive, Prospective, Population-Based Study in the Netherlands
Introduction: There is a paucity of complete studies on incidence, causes and outcome of (aborted) sudden death (SD) in children (<21 years). We sought to comprehensively study these issues by using a multiple-source reporting system for SD in children by emergency medical services (EMS) and coroners.
Methods: We conducted a prospective, population-based study on the incidence, causes and outcome of out-of-hospital (aborted) SD in children in a contiguous region in The Netherlands with ∼2.4 million inhabitants. Information on the cause of SD, survival and neurological outcome was collected. We used a national governmental registry (Statistics Netherlands) for total mortality to assess the completeness of our data, and to calculate the contribution of SD to pediatric mortality. For children who had been treated by the EMS, the primary endpoint was neurologic intact survival.
Results: During the study period of 4.3 years, 233 cases of pediatric (aborted) SD were identified, including 12 aborted SD victims. These cases constituted 94% of all SD cases during the study period as confirmed by the national governmental registry. SD accounted for 25% of total pediatric mortality. The incidence of pediatric SD was 9.0 (95% confidence interval, 7.8–10.3), while the incidence of pediatric sudden cardiac death (SCD) was 3.2 (95% confidence interval, 2.5–3.9). SCD was the most prevalent single cause of SD (39% of total pediatric SD), followed by traffic accidents (26%) (Figure 1). The overall survival to hospital discharge of resuscitated patients was 17%. The survival rates were 14% in infants (<1 year), 11% in children (1–11 years) and 27% in adolescents (12–20 years). Ninety-two percent of survivors had a neurologic intact function.
Conclusions: SD is an important cause of pediatric mortality. SCD is the most prevalent single cause of pediatric SD. The overall survival rate of pediatric SD was 17%. A large majority of survivors have neurologic intact outcome.
- © 2010 by American Heart Association, Inc.