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JAMA: Deflection and Rationalization About Deadly Out of Hospital Sudden Cardiac Arrest in Young People

stock here: you be the judge. I damn them to hell. Bottom line, 60% die before getting to hospital, of the 40% that get to a hospital, only 9% to 16% walk out of the hospital. Seems like a really broad range for something that should be known very exactly. Abstract from the article is at bottom, or use the link.

https://jamanetwork.com/journals/jama/fullarticle/2830678?guestAccessKey=ff537803-d0e0-4e71-a44c-56e1276fd229&utm_source=postup_jn&utm_medium=email&utm_campaign=article_alert-jama&utm_content=olf&utm_term=022025

A-eye sayeth:

Obtaining precise data on out-of-hospital sudden cardiac arrest (OHCA) in individuals under 40 in the U.S. over the past decade is challenging due to limited age-specific reporting. However, available information provides some insights:

Annual Incidence: Approximately 356,000 OHCAs occur annually in the U.S., with nearly 90% being fatal.
sca-aware.org

Age Distribution: Around 10% of these events occur in individuals under 40, indicating roughly 35,600 cases per year in this age group.
sca-aware.org

Youth Statistics: The Centers for Disease Control and Prevention (CDC) reports that about 2,000 seemingly healthy individuals under 25 die annually from sudden cardiac arrest.
healthychildren.org

Trends Over Time: A study analyzing cardiac arrest mortality from 1999 to 2020 noted a decline in age-adjusted mortality rates until 2019, followed by an increase in 2020. However, this study did not provide specific data for those under 40.
medrxiv.org

In summary, while exact annual data for OHCAs in individuals under 40 over the past decade is scarce, it’s estimated that this group accounts for about 10% of the total OHCA cases annually in the U.S. For more detailed statistics, consulting specialized cardiac arrest registries or studies focusing on younger populations may be beneficial.

———————————- from the article

Abstract

Importance  Out-of-hospital cardiac arrest incidence in apparently healthy adults younger than 40 years ranges from 4 to 14 per 100 000 person-years worldwide. Of an estimated 350 000 to 450 000 total annual out-of-hospital cardiac arrests in the US, approximately 10% survive.

Observations  Among young adults who have had cardiac arrest outside of a hospital, approximately 60% die before reaching a hospital (presumed sudden cardiac death), approximately 40% survive to hospitalization (resuscitated sudden cardiac arrest), and 9% to 16% survive to hospital discharge (sudden cardiac arrest survivor), of whom approximately 90% have a good neurological status (Cerebral Performance Category 1 or 2). Autopsy-based studies demonstrate that 55% to 69% of young adults with presumed sudden cardiac death have underlying cardiac causes, including sudden arrhythmic death syndrome (normal heart by autopsy, most common in athletes) and structural heart disease such as coronary artery disease. Among young adults, noncardiac causes of cardiac arrest outside of a hospital may include drug overdose, pulmonary embolism, subarachnoid hemorrhage, seizure, anaphylaxis, and infection. More than half of young adults with presumed sudden cardiac death had identifiable cardiovascular risk factors such as hypertension and diabetes. Genetic cardiac disease such as long QT syndrome or dilated cardiomyopathy may be found in 2% to 22% of young adult survivors of cardiac arrest outside of the hospital, which is a lower yield than for nonsurvivors (13%-34%) with autopsy-confirmed sudden cardiac death. Persons resuscitated from sudden cardiac arrest should undergo evaluation with a basic metabolic profile and serum troponin; urine toxicology test; electrocardiogram; chest x-ray; head-to-pelvis computed tomography; and bedside ultrasound to assess for pericardial tamponade, aortic dissection, or hemorrhage. Underlying reversible causes, such as ST elevation myocardial infarction, coronary anomaly, and illicit drug or medication overdose (including QT-prolonging medicines) should be treated. If an initial evaluation does not reveal the cause of an out-of-hospital cardiac arrest, transthoracic echocardiography should be performed to screen for structural heart disease (eg, unsuspected cardiomyopathy) or valvular disease (eg, mitral valve prolapse) that can precipitate sudden cardiac death. Defibrillator implant is indicated for young adult sudden cardiac arrest survivors with nonreversible cardiac causes including structural heart disease and arrhythmia syndromes.

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