Sudden and Unexpected Natural Death in Childhood and Adolescence
Abstract
The descriptive epidemiology of sudden nontraumatic death from persons aged 1 to 21 years was studied in a defined population. In nine years, the 207 deaths in this group (4.6/100,000 population/per year) comprised 22% of nontraumatic mortality. Age-specific rates were highest between 1 and 4 years (mainly infections and undetermined causes) and 14 and 21 years (mainly cardiovascular, epilepsy, intracranial hemorrhage, and asthma). Nonwhite rates were higher than whites, and white males had higher rates than white females. Referral for medicolegal evaluation was inconsistent. Only 18% died at university hospitals. Infections included lower respiratory tract and septic shock. The main cardiac diagnosis was myocarditis. Most epilepsy deaths were unwitnessed and had absent or low anticonvulsant levels. Eighty-five cases had a known associated chronic illness and 111 reported prodromal symptoms. Prevention of these events requires improved identification and management of antecedent conditions.
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Sudden death rates in children range from 0.8 to 8.5/100,000 patient-years.
“Sudden death rates range from 0.8 to 8.5/100,000 patient-years [20, 30, 98, 99, 159].”
From European guidelines on managing adverse effects of medication for ADHD (2011) · cites this paper as [98]
The median of published sudden death rates in children is 1.2-1.3/100,000/year.
“The median of these published sudden death rates in children is at 1.2–1.3/100,000/year.”
From European guidelines on managing adverse effects of medication for ADHD (2011) · cites this paper as [98]
Sudden death occurs only rarely in the general paediatric population.
“In contrast to adults, sudden death occurs only rarely in the general paediatric population.”
From European guidelines on managing adverse effects of medication for ADHD (2011) · cites this paper as [98]
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- Authors
- Neuspiel, D. R.
- Corresponding author
- Neuspiel, Daniel R.
- ORCID
- Neuspiel, Daniel R.
- Venue
- JAMA: The Journal of the American Medical Association
- Publisher
- American Medical Association (AMA)
- Published
- 1985-09-13
- Volume
- 254
- Issue
- 10
- Pages
- 1321
- ISSN
- 0002-9955 (ISSN-L)
- 0098-7484
- OpenAlex
- W2032839889
- Cited by
- 226
- References
- 27
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 2 · 2023: 3 · 2021: 6 · 2020: 6 · 2019: 7 · 2018: 4 · 2017: 4 · 2016: 4 · 2015: 6 · 2014: 6 · 2013: 5 · 2012: 3
- FWCI
- 3.55
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- JAMA (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Heart, Lung, and Blood Institute (T32HL007011, 5-T32-HLO7011-09)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Injury Epidemiology and Prevention
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Autopsy Techniques and Outcomes
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Neuroscience of respiration and sleep
- Keywords
- sudden unexpected death in childhood, child mortality, myocarditis, septic shock, lower respiratory tract infection, intracranial hemorrhage, asthma, forensic autopsy, prodromal symptoms, chronic disease, mortality prevention
- MeSH terms
- Adolescent, Adult, Age Factors, Asthma, Cardiovascular Diseases, Cerebral Hemorrhage, Child, Child, Preschool, Death Certificates, Death, Sudden, Epidemiologic Methods, Female, Forensic Medicine, Humans, Infant, Infections, Male, Pennsylvania, Seizures, Sex Factors, White People
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