Statewide systematic evaluation of sudden, unexpected infant death classification: Results from a national pilot project

Sabrina L. Walsh, Richard Kryscio, James W. Holsinger, Henry F. Krous

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

The Centers for Disease Control and Prevention funded seven states, including Kentucky, to clarify statewide death certification practices in sudden, unexpected infant death and compare state performances with national expectations. Accurate assignment of the cause and manner of death in cases of sudden, unexpected infant death is critical for accurate vital statistics data to direct limited resources to appropriate targets, and to implement optimal and safe risk reduction strategies. The primary objectives are to (1) Compare SUID death certifications recommended by the KY medical examiners with the stated cause of death text field on the hard copy death electronic death certificates and (2) Compare KY and national SUID rates. Causes of death for SUID cases recommended by the medical examiners and those appearing on the hard copy and electronic death certificates in KY were collected retrospectively for 2004 and 2005. Medical examiner recommendations were based upon a classification scheme devised by them in 2003. Coroners hard copy death certificates and the cause of death rates in KY were compared to those occurring nationally. Eleven percent of infants dying suddenly and unexpectedly did not undergo autopsy during the study interval. The KY 2003 classification scheme for SIDS is at variance with the NICHD and San Diego SIDS definitions. Significant differences in causes of death recommended by medical examiners and those appearing on the hard copy and electronic death certificates were identified. SIDS rates increased in KY in contrast to decreasing rates nationally. Nationwide adoption of a widely used SIDS definition, such as that proposed in San Diego in 2004 as well as legislation by states to ensure autopsy in all cases of sudden unexpected infant death are recommended. Medical examiners' recommendations for cause of death should appear on death certificates. Multidisciplinary pediatric death review teams prospectively evaluating cases before death certification is recommended. Research into other jurisdictions death certification process is encouraged.

Original languageEnglish
Pages (from-to)950-957
Number of pages8
JournalMaternal and Child Health Journal
Volume14
Issue number6
DOIs
StatePublished - Nov 2010

Bibliographical note

Funding Information:
This study was supported by the Centers for Disease Control and Prevention (424128 to S.W., National Violent Death Reporting System, SUID pilot project, supplemental funding). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of CDC. The CJ Foundation for SIDS and First Candle/SIDS Alliance provided funding support to this study. The authors wish to thank Dr. Carrie Shapiro-Mendoza for her guidance, support and editorial contribution. Sincerest gratitude is extended to the Kentucky medical examiners and coroners for their support.

Keywords

  • Death certificates
  • Death scene investigation
  • Sudden infant death syndrome
  • Sudden unexplained infant death © Classification

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Epidemiology
  • Obstetrics and Gynecology
  • Public Health, Environmental and Occupational Health

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