TOPLINE:

Age-adjusted mortality rates (AAMRs) attributable to sudden death increased across European countries from 2010 to 2020. Women experienced a faster relative increase in sudden death-attributable mortality than men; Eastern and Southern Europe showed rising trends, contrasting with declines in Western Europe.

METHODOLOGY:

• Researchers extracted data on sudden death-attributable mortality from the World Health Organization mortality dataset for 26 European countries covering 2010-2020 and examined death certificates grouped by age and sex for individuals aged 15 years or older.
• The primary cause of death was identified using diagnostic codes for sudden cardiac death, so described; cardiac arrest, unspecified; and other sudden death, cause unknown.
• A total of 2,583,559 sudden deaths (1,935,741 men and 647,818 women) were identified among 53,570,462 total deaths during the study period.
• AAMRs per 100,000 population were computed to assess trends over time for each country by sex, standardised to the European standard population.
• Subgroup analyses were conducted by sex, age group (15-29, 30-44, 45-59, 60-74, and ≥ 75 years), and European region (Northern, Western, Southern, and Eastern Europe).

TAKEAWAY:

• The overall AAMR for mortality attributable to sudden death increased from 3.75 (95% CI, 3.71-3.79) per 100,000 population in 2010 to 4.97 (95% CI, 4.92-5.03) per 100,000 population in 2020, with an average annual percent change (AAPC) of +2.9% (P < .001).
• Men demonstrated higher absolute sudden death-attributable mortality but a lower increase in the AAMR than women over the study period, with an AAPC of +3.2% in women (P < .001) vs ±2.8% in men (P = .002). Age-stratified analysis showed that AAMR increases were most pronounced in individuals aged 60-74 years (AAPC, +5.5%; P < .001) and 75 years or older (AAPC, +4.1%; P < .001).
• Regional analysis revealed divergent trends: AAMRs increased in Eastern and Southern Europe but decreased in Western Europe and plateaued in Northern Europe.
• Country-level variations showed that Austria and Hungary had lower AAMRs, whereas Poland and Latvia had the highest; Austria and Belgium demonstrated the largest reductions in AAMRs (AAPC, -8.0% and -7.9%, respectively), contrasting with the largest increases in Spain and Germany (AAPC, +3.3% and +2.8%, respectively).

IN PRACTICE:

"Enhancing primary and secondary prevention strategies remains crucial to tackling the root causes of sex and regional disparities and ensuring continued progress in reducing SD [sudden death]-related mortality," the authors of the study wrote.

SOURCE:

This study was led by Marco Zuin, University of Ferrara, Ferrara, Italy. It was published online on April 23, 2026, in The Lancet Regional Health - Europe.

LIMITATIONS:

The study relied on diagnostic codes, which may be prone to miscoding and misclassification. The absence of a uniform definition and appropriate designation affected the estimation of the true magnitude of sudden death. The dataset only captured the first cause of death, limiting the ability to characterise the aetiology of sudden death or examine secondary and tertiary causes.

DISCLOSURES:

This study did not receive any specific funding. One author disclosed receiving speaker and consultant fees from various sources including Biotronik and Boston Scientific. Another author reported serving as the principal investigator of the ARISTOTELES project that received funding from the European Union within the Horizon 2020 research and innovation programme.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.