Article Text

Original research
Incidence of sudden cardiac death in the young: a systematic review
  1. Keith Couper1,2,
  2. Oliver Putt1,
  3. Richard Field2,
  4. Kurtis Poole1,
  5. William Bradlow3,
  6. Aileen Clarke1,
  7. Gavin D Perkins1,2,
  8. Pamela Royle1,
  9. Joyce Yeung1,2,
  10. Sian Taylor-Phillips1
  1. 1Warwick Medical School, University of Warwick Warwick Medical School, Coventry, UK
  2. 2Critical Care Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
  3. 3Department of Cardiology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
  1. Correspondence to Dr Keith Couper; k.couper{at}


Objective To summarise studies describing incidence of sudden cardiac death in a general population of young individuals to inform screening policy.

Design Systematic review.

Data sources Database searches of MEDLINE, EMBASE and the Cochrane library (all inception to current) on 29 April 2019 (updated 16 November 2019), and forward/backward citation tracking of eligible studies.

Study eligibility criteria All studies that reported incidence of sudden cardiac death in young individuals (12–39 years) in a general population, with no restriction on language or date. Planned subgroups were incidence by age, sex, race and athletic status (including military personnel).

Data extraction Two reviewers independently assessed study eligibility, extracted study data and assessed risk of bias using the Joanna Briggs Institute critical appraisal checklist for prevalence studies.

Analysis Reported incidence of sudden cardiac death in the young per 100 000 person-years.

Results 38 studies that reported incidence across five continents. We identified substantial heterogeneity in population, sudden cardiac death definition, and case ascertainment methods, precluding meta-analysis. Median reported follow-up years was 6.97 million (IQR 2.34 million–23.70 million) and number of sudden cardiac death cases was 64 (IQR 40–251). In the general population, the median of reported incidence was 1.7 sudden cardiac death per 100 000 person-years (IQR 1.3–2.6, range 0.75–11.9). Most studies (n=14, 54%) reported an incidence between one and two cases per 100 000 person-years. Incidence was higher in males and older individuals.

Conclusions This systematic review identified variability in the reported incidence of sudden cardiac death in the young across studies. Most studies reported an incidence between one and two cases per 100 000 person-years.

PROSPERO registration number CRD42019120563.

  • cardiac epidemiology
  • epidemiology
  • adult cardiology
  • paediatric cardiology

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  • Contributors KC accepts full responsibility for the work and conduct of the study, had access to the data and controlled the decision to publish. KC designed the study, acted as reviewer, undertook the analysis and drafted the manuscript. OP and RF acted as reviewers. PR designed database searches. KP, WB, AC, GP, JY and ST-P contributed to study design. All authors contributed to the write up and approved the final version.

  • Funding This work was supported by Public Health England (Award/Grant number is not applicable). Public Health England originally commissioned a rapid review through the UK National Screening Committee, on which this systematic review was based. Otherwise, Public Health England had no role in study design; collection, analysis and interpretation of data; in the writing of the report and in the decision to submit the article for publication. Keith Couper had full access to all of the data (including statistical reports and tables) in the study and can take responsibility for the integrity of the data and the accuracy of the data analysis. This work was supported by the National Institute for Health Research (NIHR) Applied Research Collaboration (ARC) West Midlands (Award/Grant number is not applicable). Professor Perkins is supported as an NIHR senior investigator. Professor Taylor-Phillips is supported by an NIHR Career Development Fellowship (CDF-2016-09-018). The opinions are those of the authors and not the NIHR, the UK National Screening Committee, the NHS or the Department of Health and Social Care.

  • Competing interests All authors have completed the ICMJE uniform disclosure at and declare: KC, KP, AC, PR, GP, JY, ST-P received financial support from Public Health England for the rapid review on which this review was based; no financial relationships with any organisations that might have an interest in the submitted work in the previous 3 years; KC, JY and GP have volunteer roles with the International Liaison Committee on Resuscitation, European Resuscitation Council and Resuscitation Council UK.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as supplement information. All data relevant to the study are included in the article or uploaded as supplement information.