Zhou Yalin, Zhang Bingyin, Li Binghang, Liu Danru, Xu Chunxiao, Lu Zilong, Guo Xiaolei, Ma Jixiang
Weifang People's Hospital, Shandong Second Medical University Weifang China.
Shandong Center for Disease Control and Prevention Jinan China.
J Am Heart Assoc. 2025 Apr 15;14(8):e034423. doi: 10.1161/JAHA.124.034423. Epub 2025 Apr 10.
Sudden cardiac death (SCD) represents a public health concern globally. Given the lack of large-scale comprehensive studies on the epidemiologic features and spatial clustering of SCD in general populations, particularly in the context of cardiovascular and cerebrovascular events in China, this study aims to enrich the evidence base by analyzing its current situation in Shandong Province.
County-level data from Shandong Province (2020-2021) were used to investigate whether the incidence of SCD varied by age and sex, between urban and rural areas, among different regions, and explored whether a trend toward concentration in its temporal and spatial distribution was evident.
Shandong Province reported a total of 30 458 cases of SCD from 2020 to 2021, peaking in January to April. Most cases occurred in the older population, aged ≥65 years, comprising 78.70% of the total mortality (23 972/30 458). The male/female ratio for the average annual crude and age-standardized mortality rates was 1:0.98 and 1:0.75, respectively, whereas the urban/rural ratio was 1:1.61 and 1:1.40, respectively. Global spatial autocorrelation analysis revealed significant clustering trends of age-standardized mortality rates for both years (Moran of 0.15 and 0.13, respectively, both <0.05). Local spatial autocorrelation analysis identified "high-high" clustering areas of age-standardized mortality primarily in the northwestern cities of Shandong Province: Heze, Liaocheng, and Dezhou.
The mortality of SCD in Shandong Province during 2020 to 2021 demonstrated significant spatial clustering, with higher mortality during winter and spring. Rural older men were identified as a high-risk group. The mortality of SCD increased significantly with age.
心源性猝死（SCD）是全球关注的公共卫生问题。鉴于缺乏关于一般人群中SCD流行病学特征和空间聚集性的大规模综合研究，特别是在中国心血管和脑血管事件的背景下，本研究旨在通过分析山东省的现状来丰富证据基础。
利用山东省（2020 - 2021年）的县级数据，调查SCD发病率是否因年龄和性别、城乡之间、不同地区而异，并探讨其时间和空间分布是否存在集中趋势。
2020年至2021年山东省共报告30458例SCD病例，1月至4月达到峰值。大多数病例发生在65岁及以上的老年人群中，占总死亡率的78.70%（23972/30458）。年均粗死亡率和年龄标准化死亡率的男女比例分别为1:0.98和1:0.75，而城乡比例分别为1:1.61和1:1.40。全局空间自相关分析显示，这两年年龄标准化死亡率均有显著的聚集趋势（莫兰指数分别为0.15和0.13，均<0.05）。局部空间自相关分析确定年龄标准化死亡率的“高高”聚集区主要在山东省西北部城市：菏泽、聊城和德州。
2020年至2021年山东省SCD死亡率呈现显著的空间聚集性，冬春季节死亡率较高。农村老年男性被确定为高危人群。SCD死亡率随年龄显著增加。
