Incidence and autopsy rates of sudden cardiac death in Northern Finland

FUNDING ACKNOWLEDGEMENTS: Type of funding sources: Foundation. Main funding source(s): Sigrid Juselius foundation. Finnish foundation for cardiovascular research. BACKGROUND/INTRODUCTION: Sudden cardiac death (SCD) is one of the most common modes of death in Western societies. The exact incidence and etiological background of SCD is somewhat unknown due to the low number of autopsies performed in sudden death victims. In prior autopsy studies approximately 40% of sudden death victims have other than cardiac cause for the event and in most countries autopsy rates are between 5-25%. PURPOSE: Determine the incidence of SCD and autopsy rates for sudden death in Northern Finland. METHODS: We performed a death certificate review of all out of hospital or hospice deaths in 2016 in Northern Finland. Death was determined to be sudden if it occurred within one hour of occurrence of symptoms or if the victim was found dead. Information on autopsy, cause of death, and demographical data were collected. RESULTS: From a total of 6620 deaths 1412 occurred out of hospital/hospice. Death was classified as sudden in 1067 (16.1%) victims. Mean age was 70.1 yrs (±16.5 yrs) and 66.9% were male. Autopsy rate for all sudden deaths was 73.7%. Among victims under 70yrs autopsy rate was 90.8% and in under 50 yrs 96.2%. In all 785 autopsied sudden deaths 421 (53.6%) were SCD i.e. cardiac cause for death. In a population of 740 000 out of hospital/hospice sudden death incidence in 2016 was 144/100 000 and SCD incidence on 2016 was 77/100 000. Autopsied sudden cardiac death (N=421) was caused by ischemic heart disease (310, 73.6%), hypertensive heart disease (48, 11.4%), cardiomyopathy (50, 11.9%) or other cardiac causes (13, 3.1%). CONCLUSIONS: Autopsy rates of sudden death in Northern Finland are high. The utilization of autopsies in sudden death provide the premises for accurate SCD incidence calculations. The results confirm the assumption that a large part of sudden deaths are non-cardiac and common cardiac diseases are the most frequent cause of SCD in unselected general population.