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. 2020 Spring:2:100023.
doi: 10.1016/j.ympdx.2020.100023. Epub 2020 Mar 31.

Epidemiology of Sudden Death in a Population-Based Study of Infants and Children

Kristin M Burns  1 , Carri Cottengim  2 , Heather Dykstra  3 , Meghan Faulkner  3 , Alexa B Erck Lambert  4 , Heather MacLeod  3 , Alissa Novak  5 , Sharyn E Parks  2 , Mark W Russell  5 , Carrie K Shapiro-Mendoza  2 , Esther Shaw  3 , Niu Tian  6 , Vicky Whittemore  7 , Jonathan R Kaltman  1 ; Sudden Death in the Young Case Registry
Affiliations

Epidemiology of Sudden Death in a Population-Based Study of Infants and Children

Kristin M Burns et al. J Pediatr X. 2020 Spring.

Abstract

Objective: To describe epidemiologic data from the Sudden Death in the Young (SDY) Case Registry. Understanding the scope of SDY may optimize prevention efforts.

Study design: We analyzed sudden, unexpected deaths of infants (<365 days) and children (1-17 years) from a population-based registry of 8 states/jurisdictions in 2015 and 9 in 2016. Natural deaths and injury deaths from drowning, motor vehicle accident drivers, and infant suffocation were included; other injury deaths, homicide, suicide, intentional overdose, and terminal illness were excluded. Cases were categorized using a standardized algorithm. Descriptive statistics were used to characterize deaths, and mortality rates were calculated.

Results: Of 1319 cases identified, 92% had an autopsy. We removed incomplete cases, leaving 1132 analyzable deaths (889 infants, 243 children). The SDY rate for infants was 120/100 000 live births and for children was 1.9/100 000 children. Explained Cardiac rates were greater for infants (2.7/100 000 live births) than children (0.3/100 000 children). The pediatric Sudden Unexpected Death in Epilepsy (SUDEP) mortality rate was 0.2/100 000 live births and children. Blacks comprised 42% of infant and 43% of child deaths but only 23% of the population. In all ages, myocarditis/endocarditis was the most common Explained Cardiac cause; respiratory illness was the most common Explained Other cause. SDY occurred during activity in 13% of childhood cases.

Conclusions: Prevention strategies include optimizing identification and treatment of respiratory and cardiac diseases.

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Figures

Figure 1
Figure 1
Flow chart of SDY cases and cause-specific categories, SDY Case Registry, 2015-2016. The SDY Case Registry identified 1319 cases and analyzed 1132 of them. Autopsy rates were high. Most cases were unexplained.
Figure 2
Figure 2
A, Percentage of SDY cases by age at death, infants (n = 889), SDY Case Registry, 2015-2016. Infant SDY cases peaked at 1 and 2 months of age and tapered thereafter. B, Percentage of SDY cases by age at death, children (n = 243), SDY Case Registry, 2015-2016. Childhood SDY was lowest among children 6-9 years of age and greatest in 14- to 17-year-old children.
Figure 3
Figure 3
Number of infant and child Explained Other deaths by topic (n = 141), SDY Case Registry, 2015-2016. Respiratory illnesses caused most Explained Other cases of SDY among infants and children.
See this image and copyright information in PMC

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