Division of Cardiology, St. Michael's Hospital, Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
Division of Cardiology, St. Michael's Hospital, Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
Can J Cardiol. 2022 Nov;38(11):1715-1718. doi: 10.1016/j.cjca.2022.08.005. Epub 2022 Aug 17.
Cardiac arrest leading to death and sudden cardiac death (SCD) may refer implicitly to situations in which death is unexpected and primarily of cardiac cause. National and international societies have published differing definitions for the various terms relating to cardiac arrest and SCD. We highlight the controversies in defining SCD, including the lack of a universal definition, the heterogeneity in the operationalization of the term "sudden," and limitations of time-based systems of SCD classification. We discuss the importance of a standardized methodology for classifying cardiac arrest as recommended by the World Health Organization (WHO) that should include use of multisource evidence (eg, coroner, autopsy, and toxicology reports) for confirming or refuting a cardiac cause of arrest. We reveal how a universal definition of SCD has been incorrectly attributed to the WHO and how this has been perpetuated in the literature. We make the case that definitional clarity is essential to understanding epidemiology, evaluating novel treatments, forming international collaboration, and innovating public health prevention strategies. We propose a practical schema to categorize cardiac arrest events to describe and study this population more accurately.
心脏骤停导致的死亡和心源性猝死（SCD）可能指的是死亡出乎意料且主要由心脏原因引起的情况。国家和国际社会已经发布了与心脏骤停和 SCD 相关的各种术语的不同定义。我们强调了 SCD 定义中的争议，包括缺乏通用定义、“突然”一词的操作定义存在异质性以及基于时间的 SCD 分类系统的局限性。我们讨论了采用世界卫生组织（WHO）推荐的标准化方法对心脏骤停进行分类的重要性，该方法应包括使用多源证据（例如验尸官、尸检和毒理学报告）来确认或反驳骤停的心脏原因。我们揭示了 SCD 的通用定义是如何错误地归因于世界卫生组织的，以及这种情况是如何在文献中持续存在的。我们认为明确定义对于理解流行病学、评估新疗法、形成国际合作以及创新公共卫生预防策略至关重要。我们提出了一个实用的方案来对心脏骤停事件进行分类，以更准确地描述和研究这一人群。
