Loading…

Protocol - Sudden Cardiac Arrest

Add to Toolkit

Protocol Name from Source:

The Expert Review Panel has not reviewed this measure yet.

Availability:

Publicly available

Description:

This measure assesses if a patient died of sudden cardiac arrest by reviewing symptoms prior to death, timing of death, possible cardiac origin via autopsy evidence, and/or demonstration of a history of cardiac disease via physician questionnaire and medical records review.

Protocol:

To be completed by physician who signed the death certificate and/or the patient's physician.

1. Are you familiar with the events surrounding the decedent's death?

[] Yes

[] No

2. Did you witness the death?

[] Yes

[] No

If you answered No to both 1 and 2, skip to end. Otherwise, continue with item 3.

3a. Was there any pain in the chest, left arm or shoulder or jaw within 72 hours of death?

[] Yes

[] No

[] Uncertain

If No or Uncertain, skip to item 4.

3b. Did the pain include the chest?

[] Yes

[] No

[] Uncertain

3c. Did you think this pain was of a cardiac origin?

[] Yes

[] No

[] Uncertain

If No, specify what you think was the cause:

4. Was cardiopulmonary resuscitation (CPR) and/or cardioversion performed within 24 hours of death?

[] Yes

[] No

[] Uncertain

5. Please give time between onset of acute symptoms to death. (We are defining death as the point where spontaneous breathing ceased and the patient never recovered.)

[] More than three days

[] Two - three days

[] One day

[] At least 12 hours, but less than 24 hours

[] At least 4 hours, but less than 12 hours

[] At least 1 hour, but less than 4 hours

[] Less than 1 hour

[] Death instantaneous, no symptoms

[] Unknown

6. Would you classify the decedent's cause of death as due to Coronary Heart Disease (CHD)?

[] Yes

[] No

[] Uncertain

To be abstracted from patient's hospital medical records.

7. Location of death:

[] Out-of-Hospital

[] Emergency Room (not dead on arrival—DOA)

[] In Hospital

[] Nursing Home, Skilled Nursing Facility (SNF), or Extended Care Facility (ECF)

[] Other, specify:

8. Was the death witnessed?

[] Yes

[] No

[] Unknown

9. Multi-Ethnic Study of Atherosclerosis (MESA) classification of underlying cause of death (choose one):

[] Atherosclerotic coronary heart disease (complete questions 10, 11 and 12 only)

[] Stroke (skip to end)

[] Atherosclerotic disease other than coronary disease or stroke (specify): _______________________________ (complete question 12 only)

[] Other cardiovascular disease, not defined above (specify):_______________________________ (complete question 12 only)

[] Non-cardiovascular disease (specify):_______________________________ (skip to end)

[] Unknown because death certificate unavailable (skip to end)

10. Type of fatal coronary heart disease:

[] Definite fatal myocardial infarction (MI) (no known non-atherosclerotic cause and definite myocardial infarction within 4 weeks of death)

[] Definite fatal coronary heart disease (CHD) (no known non-atherosclerotic cause, and one or both of the following: chest pain within 72 hours of death or a history of chronic ischemic heart disease)

[] Possible fatal coronary heart disease (CHD) (no known non-atherosclerotic cause, and death certificate underlying cause: I20-25, I46, I51.6, R96 or R98-99)

11. Estimated time between onset of acute cardiac symptoms and death:

[] Less than five minutes

[] five minutes to one hour

[] one hour to 24 hours

[] More than 24 hours

[] Unknown

12. Mechanism of death in patients dying of cardiovascular causes (check all that apply):

[] Primary arrhythmic death

[] Secondary arrhythmic/mechanical death

[] Congestive heart failure (CHF)

[] Cardiac procedure such as coronary artery bypass graft (CABG) or angioplasty

[] Hemorrhage from thrombolytic therapy

[] Other (specify):_______________________________

[] Unknown or Uncertain

Personnel and Training Required

A trained and certified Hospital Record Abstractor is required to complete the protocol from Multi-Ethnic Study of Atherosclerosis (MESA). This person should be trained on how to perform medical record and chart abstraction using various hospital records.

A physician who signed the death certificate and/or the patient's physician.

Equipment Needs

None

Requirements

Requirement CategoryRequired
Average time of greater than 15 minutes in an unaffected individualNo
Major equipmentNo
Specialized requirements for biospecimen collectionNo
Specialized trainingYes

Mode of Administration

Self-administered

Life Stage:

Adult

Specific Instructions:

These protocols should be completed for cases where patients did not survive a sudden cardiac arrest. The physician's questionnaire from the Atherosclerosis Risk in Communities (ARIC) study is to be completed by the physician who signed the death certificate and/or the patient's physician. The second protocol, from the Multi-Ethnic Study of Atherosclerosis (MESA), provides items that should be abstracted from the patient's hospital records.

Research Domain Information

Release Date:

September 9, 2009

Definition

Measure to assess if patient died of sudden cardiac arrest.

Purpose

To determine if a patient died of sudden cardiac arrest through a physician's assessment of the patient's conditions and medical record abstraction to make a determination of the probability of coronary heart disease, peripheral vascular disease and cerebral vascular disease.

Selection Rationale

Two protocols were chosen to obtain sufficient data to assess whether a patient died of sudden cardiac arrest. Obtaining this information from a physician, in combination with medical records, will provide a high level of specificity and reliability.

Language

English, Spanish

Standards

StandardNameIDSource
Common Data Elements (CDE)Death From Cardiac Arrest Indicator2935447CDE Browser
Logical Observation Identifiers Names and Codes (LOINC)Sudden cardiac arrest proto62396-7LOINC

Process and Review

The Expert Review Panel has not reviewed this measure yet.

Source

U.S. Department of Health and Human Services. National Institutes of Health. National Heart, Lung and Blood Institute. Atherosclerosis Risk in Communities (ARIC). Physician Questionnaire Form. Questions 5–7 (source for questions 1–3 in Protocol Text), questions 10–12 (source for questions 4–6).

U.S. Department of Health and Human Services. National Institutes of Health. National Heart, Lung and Blood Institute. Multi-Ethnic Study of Atherosclerosis (MESA). Mortality Review Form. Questions 1–6 (source for questions 7–12).

General References

For the Multi-Ethnic Study of Atherosclerosis (MESA) hospital record abstraction diagnosis criteria, see MESA Clinical Events Manual of Procedures, Section 4.2: Criteria for Deaths.

http://www.mesa-nhlbi.org/PublicDocs/MesaMOO/Appendix11_MESA_ClinicalEvents_MOP.pdf

Protocol ID:

40701

Variables:

Export Variables
Variable NameVariable IDVariable DescriptionVersiondbGaP Mapping
PX040701_Physician_Familiar_With_EventPX040701010000Are you familiar with the events surrounding the decedent's death?4N/A
PX040701_Physician_Witness_DeathPX040701020000Did you witness the death?4N/A
PX040701_PainPX040701030100Was there any pain in the chest, left arm or shoulder or jaw within 72 hours of death?4N/A
PX040701_Pain_Include_ChestPX040701030200Did the pain include the chest?4N/A
PX040701_Pain_Cardiac_OriginPX040701030300Did you think this pain was of a cardiac origin?4N/A
PX040701_Pain_Cardiac_Origin_Specify_CausePX040701030301Did you think this pain was of a cardiac origin? If no, specify what you think was the cause.4N/A
PX040701_CPRPX040701040000Was cardiopulmonary resuscitation (CPR) and/or cardioversion performed within 24 hours of death?4N/A
PX040701_Symptom_TimePX040701050000Please give time between onset of acute symptoms to death. (We are defining death as the point where spontaneous breathing ceased and the patient never recovered).4N/A
PX040701_CHDPX040701060000Would you classify the decedent's cause of death as due to Coronary Heart Disease (CHD)?4N/A
PX040701_LocationPX040701070000Location of death4N/A
PX040701_Location_Other_SpecifyPX040701070100Location of death4N/A
PX040701_Witness_RecordPX040701080000Was the death witnessed?4N/A
PX040701_CausePX040701090000Multi-Ethnic Study of Atherosclerosis (MESA) classification of underlying cause of death (choose one)4N/A
PX040701_Cause_Other_Atherosclerotic_Disease_SpecifyPX040701090100Multi-Ethnic Study of Atherosclerosis (MESA) classification of underlying cause of death: Atherosclerotic disease other than coronary disease or stroke (specify)4N/A
PX040701_Cause_Other_Cardiovascular_Disease_SpecifyPX040701090200Multi-Ethnic Study of Atherosclerosis (MESA) classification of underlying cause of death: Other cardiovascular disease, not defined above (specify)4N/A
PX040701_Cause_Noncardiovascular_Disease_SpecifyPX040701090300Multi-Ethnic Study of Atherosclerosis (MESA) classification of underlying cause of death: Non-cardiovascular disease (specify)4N/A
PX040701_Fatal_CHD_TYPEPX040701100000Type of fatal coronary heart disease.4N/A
PX040701_Symptom_Time_EstimatedPX040701110000Estimated time between onset of acute cardiac symptoms and death.4N/A
PX040701_MechanismPX040701120000Mechanism of death in patients dying of cardiovascular causes (check all that apply).4N/A
PX040701_Mechanism_Other_SpecifyPX040701120100Mechanism of death in patients dying of cardiovascular causes4N/A