Sudden unexpected cardiac death among the young (5 to 40 years) in Switzerland between 2011 and 2019: incidence and autopsy rate.

The investigation of sudden cardiac death (SCD) in young individuals should be performed by a forensic pathologist. Considerable variability in the incidence of SCD in the young is reported in European studies, ranging from 0.4 to 13.6 /100’000 person-year and an autopsy is performed in 40% of the cases of SCD in the young. However data are missing in many countries including Switzerland. Therefore, the aims of this retrospective study were to determine the incidence of SCD and to evaluate the autopsy rate of SCD in Switzerland, for individuals aged from 5 to 40 years of age. The study was conducted based on the data provided by the Federal Office of Public Health (FOPH) for all Swiss cantons, from 2011 to 2019, with analysis of the International Classification of Diseases 10th Revision (ICD-10) codes for potential SCDs. During the period of the study, there were 1322 deaths, from which 494 deaths corresponding to the ICD-10 codes “diseases of the cardiovascular system” (ICD-10 codes I05-I09, I10-I15, I20-I25 and I30-I52) and 828 deaths corresponding to the ICD-10 codes “unknow causes of death” (R96-R99). National incidence of SCD in Switzerland has been calculated to be 4.13/100’000 person-year, showing a great variability between Swiss cantons, possibly suggesting different cantonal approaches in managing SCD cases. Autopsy rates for SCD cases in Switzerland have been calculated to be 30%. A homogenous management of SCD, an increased autopsy rate and a better management of the results of autopsies are strongly advised which could optimize the quality of statistical data and a better clinical approach for families of SCD victims.