Risgaard Bjarke, Lynge Thomas Hadberg, Wissenberg Mads, Jabbari Reza, Glinge Charlotte, Gislason Gunnar Hilmar, Haunsø Stig, Winkel Bo Gregers, Tfelt-Hansen Jacob
Danish National Research Foundation Centre for Cardiac Arrhythmia (DARC), University of Copenhagen, Copenhagen, Denmark; Laboratory of Molecular Cardiology, Department of Cardiology, The Heart Centre, Copenhagen 3 University Hospital, Rigshospitalet, Copenhagen, Denmark.
Danish National Research Foundation Centre for Cardiac Arrhythmia (DARC), University of Copenhagen, Copenhagen, Denmark; Laboratory of Molecular Cardiology, Department of Cardiology, The Heart Centre, Copenhagen 3 University Hospital, Rigshospitalet, Copenhagen, Denmark.
Heart Rhythm. 2015 May;12(5):968-74. doi: 10.1016/j.hrthm.2015.01.024. Epub 2015 Jan 19.
On the performance of an autopsy, sudden deaths may be divided into 2 classifications: (1) sudden cardiac deaths and (2) sudden noncardiac deaths (SNCDs). Families of SNCD victims should not be followed up as a means of searching for cardiac disease.
The purpose of this study was to report the risk factors and causes of SNCD.
We conducted a retrospective, nationwide study including all deaths between 2000 and 2006 of individuals aged 1-35 years and all deaths between 2007 and 2009 of individuals aged 1-49 years. Two physicians identified all sudden death cases through review of death certificates. Autopsy reports were collected. A multivariable logistic regression model was used to identify both clinical characteristics and risk factors associated with SNCD.
We identified 1039 autopsied cases of sudden death, of which 286 (28%) were classified as SNCD. The median age in the SNCD death population was 32 years. Increasing age was inversely associated with SNCD (odds ratio [OR] 0.93, 95% confidence interval [CI] 0.87-0.98). Female sex, in-hospital location, and the absence of cardiac comorbidities were positively associated with SNCD (OR 1.7, 95% CI 1.3-2.3; OR 3.0, 95% CI 2.0-4.4; and OR 4.3, 95% CI 2.5-7.4, respectively). The most common cause of SNCD was pulmonary disease (n = 115 [40%]).
Sudden death among individuals aged <50 years was caused by noncardiac diseases in 28% of cases. Risk factors were female sex, age, and the absence of cardiac comorbidities. These data may guide future strategies for the follow-up of family members of nonautopsied sudden death victims, improve risk stratification, and influence public health strategies.
在尸检过程中，猝死可分为两类：（1）心源性猝死和（2）非心源性猝死（SNCD）。不应将SNCD受害者的家属作为筛查心脏病的对象进行随访。
本研究旨在报告SNCD的危险因素和病因。
我们开展了一项全国性回顾性研究，纳入了2000年至2006年期间所有1至35岁个体的死亡病例以及2007年至2009年期间所有1至49岁个体的死亡病例。两名医生通过查阅死亡证明确定所有猝死病例。收集尸检报告。采用多变量逻辑回归模型确定与SNCD相关的临床特征和危险因素。
我们确定了1039例经尸检的猝死病例，其中286例（28%）被归类为SNCD。SNCD死亡人群的中位年龄为32岁。年龄增长与SNCD呈负相关（比值比[OR]为0.93，95%置信区间[CI]为0.87 - 0.98）。女性、住院地点以及无心脏合并症与SNCD呈正相关（OR分别为1.7，95%CI为1.3 - 2.3；OR为3.0，95%CI为2.0 - 4.4；OR为4.3，95%CI为2.5 - 7.4）。SNCD最常见的病因是肺部疾病（n = 115 [40%]）。
50岁以下个体中，28%的猝死由非心脏疾病引起。危险因素包括女性、年龄以及无心脏合并症。这些数据可为未来非尸检猝死受害者家属的随访策略提供指导，改善风险分层，并影响公共卫生策略。
