Department of Emergency Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan; Department of Emergency Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan.
Prev Med. 2024 Oct;187:108102. doi: 10.1016/j.ypmed.2024.108102. Epub 2024 Aug 14.
Few reports have indicated the secular trend in the sudden cardiac death (SCD) incidence and pre-arrest comorbidities. This study aimed to comprehensively analyze the trend of SCD incidence and its association with pre-arrest comorbidities.
This population-based cohort study analyzed Taiwan's National Health Insurance (NHI) research database and identified SCD incidents by inspecting data from all emergency department visits from 2011 to 2018. The inclusion criteria were ICD-9:427.5 or 427.41, or ICD-10:I46.9, I46.8, or I46.2. Pre-existing comorbidities were confirmed based on medication use. Multivariable logistic regression was adopted with covariates age, sex, and pre-existing comorbidities.
This study reviewed a total of 184,164,969 person-year records, and identified 92,138 SCD incidents. From 2011 to 2018, the SCD incidence rate increased from 36.3 to 55.4 per 100,000 enrollees in Taiwan. The top five pre-arrest comorbidities were stable, while the prevalence of chronic kidney disease rose significantly. Compared to those aged 20-29, enrollees aged >65 years had significantly higher odds of SCD (aOR:27.30, 95% CI:26.05-28.61). Higher odds of SCD were noted in the enrollees who had a seizure (aOR:2.24, 95% CI:2.12-2.38), parkinsonism (aOR:1.81, 95% CI:1.73-1.89), psychological disorders (aOR:1.59, 95% CI:1.56-1.62), diabetes mellitus (aOR:1.44, 95% CI:1.41-1.46), heart diseases (aOR:1.41, 95% CI:1.38-1.44).
The incidence of SCD steadily increased in Taiwan from 2011 to 2018. Hypertension, diabetes mellitus, heart disease, psychological disorders, and arthritis were major pre-arrest comorbidities. Age is the most important risk factor for SCD. Further large-scaled population-based study that investigated in diverse ethnicities from countries in addition to Asians would be warranted.
鲜有报告表明心脏性猝死 (SCD) 发生率和发病前合并症的长期变化趋势。本研究旨在全面分析 SCD 发生率的变化趋势及其与发病前合并症的关系。
本基于人群的队列研究分析了台湾全民健康保险（NHI）研究数据库，并通过检查 2011 年至 2018 年所有急诊就诊数据，确定了 SCD 事件。纳入标准为 ICD-9：427.5 或 427.41，或 ICD-10：I46.9、I46.8 或 I46.2。根据用药情况确定预先存在的合并症。采用多变量逻辑回归分析，协变量为年龄、性别和预先存在的合并症。
本研究共回顾了 184164969 人年记录，共确定了 92138 例 SCD 事件。2011 年至 2018 年，台湾 SCD 发生率从 36.3/10 万上升至 55.4/10 万。发病前的前 5 种合并症保持稳定，而慢性肾脏病的患病率显著上升。与 20-29 岁年龄组相比，>65 岁年龄组发生 SCD 的几率明显更高（OR：27.30，95%CI：26.05-28.61）。患有癫痫（OR：2.24，95%CI：2.12-2.38）、帕金森病（OR：1.81，95%CI：1.73-1.89）、心理障碍（OR：1.59，95%CI：1.56-1.62）、糖尿病（OR：1.44，95%CI：1.41-1.46）和心脏病（OR：1.41，95%CI：1.38-1.44）的患者发生 SCD 的几率更高。
2011 年至 2018 年，台湾 SCD 的发病率稳步上升。高血压、糖尿病、心脏病、心理障碍和关节炎是发病前的主要合并症。年龄是 SCD 的最重要危险因素。需要进一步开展基于大样本、人群的研究，以调查除亚洲以外的其他国家和地区的不同种族。
