• Ching-Yu Chen, Edward Pei-Chuan Huang, Cheng-Yi Fan, Chun-Hsiang Huang, Sih-Shiang Huang, Chi-Hsin Chen, Chien-Tai Huang, Yun-Chang Chen, WenChu Chiang, Chien-Hua Huang, and Chih-Wei Sung.
• Department of Emergency Medicine, National Taiwan University Hospital Yun-Lin Branch, Yun-Lin, Taiwan.
• Am J Prev Med. 2025 Jan 27.

IntroductionThis study aimed to investigate the patterns of healthcare system utilization before sudden cardiac death (SCD) in Taiwan, and compare the patterns between patients treated at medical centers and non-center hospitals.MethodsThis descriptive multicenter retrospective cohort study recruited adult, nontraumatic SCD patients who were admitted to the National Taiwan University Hospital and its affiliated hospitals between January 2017 and December 2022. Healthcare utilization patterns, such as outpatient visits, emergency department (ED) visits, short-term ED returns, and hospitalizations, were analyzed during the weeks prior to SCD. The statistical analysis compared the above patterns between medical center and non-center cohorts to identify potential differences in patient behavior and healthcare use.ResultsAnalysis of 3,649 eligible patients revealed a significant increase in healthcare utilization before SCD. Outpatient visits began to rise sharply five weeks prior to SCD, peaking at 16.5% in the overall cohort. The number of ED visits showed a notable increase starting ten weeks prior, with a peak in the week immediately before the SCD, reaching 3.7%. Hospitalization rates exhibited a distinct pattern, peaking at 2.5% three weeks before SCD and then declining. The consistency between hospitalization diagnoses and the cause of SCD was approximately 40% within three weeks prior to SCD. The increases were consistent across both the medical center and non-center cohorts, although non-center patients generally exhibited higher utilization rates.ConclusionsHealthcare utilization significantly increased before SCD, including outpatient visits, ED visits, and hospitalization. This pattern was consistent among patients treated at medical centers and non-medical centers.Copyright © 2025. Published by Elsevier Inc.

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