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- Title
Diurnal, weekly and seasonal variation of sudden death. Population-based analysis of 24061 consecutive cases.
- Authors
Arntz, H.-R; Willich, S.N; Schreiber, C; Brüggemann, T; Stern, R; Schultheiß, H.-P
- Abstract
Aims Several studies have reported circadian and seasonal variations in acute cardiovascular disease. In addition, a weekly variation has been observed in acute myocardial infarction. The aim of our study was to determine the circadian weekly, and seasonal variations of sudden death utilizing population-based data.Methods and Results We analysed the emergency medical system data of Berlin (West) from 1987–1991 with respect to all consecutive sudden deaths in subjects >18 years (n=24061). There was a marked circadian variation of sudden death, with a minimum between 0 and 6h and a maximum between 6 and 12h (P<0·0001) for every day of the week. A minimum of events occurred on Sundays (n=3143), and a maximum on Mondays (n=3721), corresponding to a relative increase of 18·3% (P<0·0001). The increase was more pronounced (23·6%) in patients ≤65 than in patients >65 (15·7%). In addition, we found a significant seasonal variation (P<0·0001) in events, with a maximum during winter (December to February, n=6493), and a minimum during summer (June to August, n=5472), corresponding to a relative difference of 18·7%. The seasonal variation was more pronounced in patients >65 years.Conclusion The present analyses demonstrate marked variations in the occurrence of sudden death with peaks during morning hours, on Mondays, and during winter months. The findings suggest that the onset of sudden death may be associated with endogenous rhythms and external factors including climatic conditions.
- Publication
European Heart Journal, 2000, Vol 21, Issue 4, p315
- ISSN
0195-668X
- Publication type
Article
- DOI
10.1053/euhj.1999.1739