Abstract

ABSTRACT Background: Sudden death (SD) among working-aged population is rare but devastating. Understanding the incidence and causes of SD is essential in the development of preventive strategies. Aims &
Objective: To investigate the incidence, risk factors and comorbidities in 15-64 years old population in Taiwan.
Materials and Methods: Incidence rates and causes of death were determined using the Taiwanese National Health Insurance Research Database (NHIRD) recorded between 2000 and 2009. Deaths were identified using the International Classification of Disease (ICD) codes. Poisson regression models were used to assess the relative risks (RRs) associated with the gender, age, seasonal and day-of-the-week variables.
Results: A total of 1269 males (73.8%) and 451 females (26.2%) SD cases were identified from a cohort of 1 million beneficiaries. The annual incidence of SD increased by10.3% from 2000 (14.5 per 100000 person-years) to 2009 (24.8 per 100000 person-years). The 10-year cumulative SD incidence was highest among people aged 55-64 years (794.3) and lowest among people aged 15-24 years (92.4). In all year and age groups, incidence rates were significantly higher among males than females (P<0.01). After adjusting for gender and age, increased risk of SD were noted 55-64 years (RR: 1.3, 95% CI: 0.1 to 1.5, p=0.000), in winter (RR: 0.10, 95% CI: 0.0 to 0.3, p=0.006) and on Mondays (RR: 0.19, 95% CI: 0.0 to 0.2, p=0.04). Cardiovascular causes accounted for the majority of medical comorbidities for SD (73.9%), mostly due to hypertension (incidence rates: 26.1%). Conclusion: Male, 55-64 years-old, winter and Monday were major determinants of SD in Taiwan. Cardiovascular disease prevention and health promotion programs may help reduce the risk of SD.