title: Population-based analysis of sudden death in children: The Oregon Sudden Unexpected Death Study.
abstract: BACKGROUND
  There is a lack of prospective population-based data regarding sudden death in children.
  
  
  OBJECTIVE
  The purpose of this study was to assess the burden of sudden cardiac arrest (SCA) in the pediatric population in a 3-year community-wide study.
  
  
  METHODS
  During 2002-2005, all residents of Multnomah County, Oregon (population 660,486) who underwent SCA were ascertained from emergency medical services, the medical examiner, and emergency rooms of 16 area hospitals. A comprehensive evaluation was performed, including analysis of circumstances of death, medical records, and available autopsy data. Annual incidence rates were calculated for all residents age <18 years using the 2000 U.S. Census data.
  
  
  RESULTS
  A total of 33 children met the criteria for SCA (58% female, median age 0.37 years, range 0.03-12.3 years). The majority of SCAs (76%) occurred in children age <1 year. At least 90% of this subgroup also met the criteria for the sudden infant death syndrome (SIDS). Pediatric SCAs constituted 2.8% of all SCAs. The pediatric annual incidence rate per 100,000 population was 1.7 (95% confidence interval [CI] 1.1-2.3), compared with 60/100,000 for all ages. The pediatric annual incidence rate per 100,000 children was 7.5 (95% CI 5.1-10.5). The annual incidence rate of SIDS was 0.8/1000 live births. In contrast to an adult survival rate of 8%, none of the children survived to be discharged from the hospital.
  
  
  CONCLUSIONS
  The burden of pediatric sudden death was low (3% of all sudden deaths), but 90% occurred before the age of 1 year, and the majority were diagnosed as SIDS (70% of overall sudden deaths in children). Population education to prevent SIDS and enhanced postnatal diagnosis of occult heart disease are likely to have the greatest impact on the prevention of pediatric sudden death.
authors.affiliation: Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California 90048 sumeet.chugh@cshs.org
authors.forename: Sumeet S
authors.initials: SS
authors.lastname: Chugh
authors.forename: Kyndaron
authors.initials: K
authors.lastname: Reinier
authors.forename: Seshadri
authors.initials: S
authors.lastname: Balaji
authors.forename: Audrey
authors.initials: A
authors.lastname: Uy-Evanado
authors.forename: Cathy
authors.initials: C
authors.lastname: Vickers
authors.forename: Ronald
authors.initials: R
authors.lastname: Mariani
authors.forename: Karen
authors.initials: K
authors.lastname: Gunson
authors.forename: Jonathan
authors.initials: J
authors.lastname: Jui
mesh_terms: D002648:Child; D002675:Child, Preschool; D017281:Cost of Illness; D016757:Death, Sudden, Cardiac / Q000453:epidemiology* / Q000209:etiology*; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D009922:Oregon / Q000453:epidemiology