USE AND ACCURACY OF STATE DEATH CERTIFICATES FOR CLASSIFICATION OF SUDDEN CARDIAC DEATHS IN HIGH-RISK POPULATIONS

In a large cohort of patients with known or suspected coronary disease , we evaluated the characteristics of 407 patients who died after hosp ital discharge and tested whether the state death certificate con be u sed to classify deaths as sudden cardiac versus nonsudden, Compared wi th a paramedic classification system based on heart rhythm, the death certificate-based classification resulted in a sensitivity that ranged from 78% to 85% and a specificity that ranged from 25% to 58%. We con clude that the death certificate con be used to identify cases of sudd en cardiac death in patients at high risk; however, there is a substan tial rate of false-positive sudden death classification.