Out-of-hospital cardiac deaths in adolescents and young adults in the United States, 1989 to 1998.
BACKGROUND
Out-of-hospital cardiac death (OHCD), often occurring suddenly and unexpectedly, is a major public health problem. The purpose of this study is to assess the epidemiologic pattern and secular trend of OHCD in adolescents and young adults aged 15-34 years in the United States.


METHODS
United States national vital statistics mortality data from 1989 to 1998 were analyzed. OHCD was defined as death that occurred either at a pre-transport location, or in the emergency room, or was classified as "dead on arrival" in the emergency room, with an underlying cause of death as a cardiac disease (ICD-9 codes 390-398, 402, 404-429, 745, or 746).


RESULTS
Of the 48,573 cardiac deaths occurring during 1989 to 1998, 31,827 (66%) were out of hospital. Of all OHCD victims from 1989 to 1998, 70% were men, and 76% were aged 25-34 years. The leading underlying causes of OHCD were coronary heart disease (29%), cardiomyopathy (18%), and arrhythmias (14%). The OHCD rates (per million population) were twice as high in men as in women (57.0 vs. 26.7 in 1997 and 1998), in African Americans as in whites (84.9 vs. 35.9 in 1997 and 1998), and increased with age. From 1989-1990 to 1997-1998, the age-adjusted OHCD death rates increased in both men (11%) and women (33%), and in African Americans (11%) and whites (19%).


CONCLUSIONS
Although cardiac death remains rare in U.S. adolescents and young adults, the increased trend in OHCD rates in this age group warrants further investigation of etiology and prevention strategies.
Zheng
Zhi-Jie
ZJ
Cardiovascular Health Branch, Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia 30341-3717, USA. zzheng@cdc.gov
Croft
Janet B
JB
Giles
Wayne H
WH
Mensah
George A
GA
D000293:Adolescent; D000328:Adult; D003643:Death; D005260:Female; D006801:Humans; D008297:Male; D009026:Mortality / Q000639:trends*; D014481:United States / Q000453:epidemiology; D014798:Vital Statistics