TraCS-affiliated faculty publish research in NC Medical Journal on Sudden Death
Congratulations to Ross Simpson, MD, PhD, chair of the NC TraCS Institute Data Safety Monitoring Board, and Feng-Chang Lin, PhD, Associate Professor in the Department of Biostatistics and an NC TraCS biostatistician, for their recent publication, Missed Opportunities for Prevention of Sudden Death, in the North Carolina Medical Journal.
TraCS has supported this research in several ways, including support from our biostatistics, regulatory, and informatics and data science programs.
Missed Opportunities for Prevention of Sudden Death
Aamir Husain, Elham A. Masoudi, Mojtaba Mirzaei, Golsa Joodi, Murrium I. Sadaf, Feng-Chang Lin and Ross J. Simpson
North Carolina Medical Journal March 2021, 82 (2) 95-99; DOI: doi.org/10.18043/ncm.82.2.95
Abstract
BACKGROUND: We assessed patterns of health care utilization to further characterize chronic comorbidities prior to sudden death.
METHOD: From March 1, 2013, through February 28, 2015, all out-of-hospital deaths aged 18-64 reported by emergency medical services in Wake County, North Carolina, were screened to adjudicate 399 sudden death victims. Retrospective analysis of clinical records on victims determined health care utilization. Health care utilization frequency was assessed by latent growth curve analysis.
RESULTS: Medical records were available for 264 victims (aged 53.5 ± 9.2) who were predominantly male (65%) and white (64%). Of these, 210 (80%) victims had at least one visit within two years of death and 73 (28%) had a visit within one month of death. Over the two years prior to death, there was an increasing frequency of doctor visits (P & < .001). Victims averaged 3.7 ± 4.6 yearly visits and were categorized into low (0.4 visits/year), medium (3.3 visits/year), and high (11.4 visits/year) tiers of visit frequency. The high visit tier had a greater prevalence of coronary artery disease (38%), hypertension (80%), diabetes (58%), depression (74%), anxiety (64%), and substance misuse (46%) (P < .001).
LIMITATIONS: Those who were non-free-living, minors, without formal medical records, and adults aged 65 and older were excluded from the analysis.
CONCLUSIONS: A majority of sudden death victims utilized health care within two years prior to death and had comorbidities that may have contributed to their unexpected death. The increasing frequency of visits prior to death provided an opportunity for health care providers to address potential victims' chronic medical conditions to potentially prevent death.
Sudden death is one of the leading causes of death in the United States [1-5]. Efforts to prevent sudden death are not often undertaken, as these deaths are often considered unexpected and the first manifestation of cardiovascular disease [1, 6, 7]. However, recent research from our group suggests that sudden death victims often have multiple medical conditions that may cause or contribute to their death [8, 9]. In order to assess possible opportunities for prevention of sudden death, we assessed health care utilization in the two years prior to sudden death within a population sample of sudden death victims.
