Cardiovascular deaths in children: general overview from the National Center for the Review and Prevention of Child Deaths.
BACKGROUND
Cardiovascular conditions rank sixth in causes of death in 1- to 19-year-olds. Our study is the first analysis of the cardiovascular death data set from the National Center for the Review and Prevention of Child Deaths, which provides the only systematic collection of cardiovascular deaths in children.


METHODS
We developed an analytical data set from the National Center for the Review and Prevention of Child Deaths database for cardiovascular deaths in children 0 to 21 years old, reviewing 1,098 cases from 2005 to 2009 in 16 states who agreed to participate.


RESULTS
Cardiovascular cases were aged 4.8 ± 6.6 years; 55.3%, ≤1 year; 24.6%, ≥10 years; male, 58%; white, 70.5%; black, 22.3%; Hispanic, 19.5%. Prior conditions were present in 48.5%: congenital heart disease, 23%; cardiomyopathies, 4.6%; arrhythmia, 1.7%; and congestive heart failure, 1.6%. Deaths occurred most frequently in urban settings, 49.2%; and in the hospital, 40.4%; home, 26.1%; or at school/work/sports, 4.8%. Emergency medical services were not evenly distributed with differences by age, race, ethnicity, and area. Autopsies (40.4%) occurred more often in those >10 years old (odds ratio [OR] 2.9), blacks (OR 1.6), or in those who died at school/work/sports (OR 3.9). The most common cardiovascular causes of death included congenital heart disease, 40.8%; arrhythmias, 27.1%; cardiomyopathy, 11.8%; myocarditis, 4.6%; congestive heart failure, 3.6%; and coronary artery anomalies, 2.2%.


CONCLUSIONS
Our study identified differences in causes and frequencies of cardiovascular deaths by age, race, and ethnicity. Prevention of death may be impacted by knowledge of prior conditions, emergency plans, automated external defibrillator programs, bystander cardiopulmonary resuscitation education, and by a registry for all cardiovascular deaths in children.
The Children's Hospital of Philadelphia, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA. Electronic address: vetter@email.chop.edu.
Victoria L
VL
Vetter
Michigan Public Health Institute, National Center for Review and Prevention of Child Deaths, Okemos, MI.
Theresa M
TM
Covington
The Children's Hospital of Philadelphia, Philadelphia, PA.
Noreen P
NP
Dugan
The Children's Hospital of Philadelphia, Philadelphia, PA.
Danielle Main
DM
Haley
Michigan Public Health Institute, National Center for Review and Prevention of Child Deaths, Okemos, MI.
Heather
H
Dykstra
Private Research Consultant, Santa Fe, New Mexico.
Mary
M
Overpeck
The Children's Hospital of Philadelphia, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA.
V Ramesh
VR
Iyer
The Children's Hospital of Philadelphia, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA.
Justine
J
Shults
D001145:Arrhythmias, Cardiac / Q000401:mortality; D009202:Cardiomyopathies / Q000401:mortality; D002318:Cardiovascular Diseases / Q000401:mortality*; D002423:Cause of Death; D002648:Child; D046688:Child Mortality / Q000639:trends; D002675:Child, Preschool; D005260:Female; D006330:Heart Defects, Congenital / Q000401:mortality; D006801:Humans; D008297:Male; D014481:United States / Q000453:epidemiology