Journal
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
Volume 79, Issue 3, Pages 238-246Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jacc.2021.11.011
Keywords
basic life support; prevention; resuscitation; sports; sudden death; temporal trends
Categories
Funding
- French National Institute of Health and Medical Research (INSERM), University of Paris, French Federation of Cardiology
- Institut National de la Sante et de la Recherche Medicale (INSERM)
- University of Paris
- Assistance Publique-Hopitaux de Paris
- Fondation Coeur et Arteres
- Global Heart Watch
- Federation Francaise de Cardiologie
- Societe Francaise de Cardiologie
- Fondation Recherche Medicale
- European Commission
- Medtronic
- St. Jude Medical
- Boston Scientific
- MicroPort
- Biotronik
- Zoll
- Schiller
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This study assessed the temporal trends in incidence, management, and survival of sports-related sudden cardiac arrest (SrSCA). The results showed that SrSCA incidence remained stable over time, but improvements in on-field resuscitation and public automated external defibrillator use led to a significant increase in survival.
BACKGROUND Major efforts have been made to reduce the burden of sports-related sudden cardiac arrest (SrSCA). The extent to which the incidence, management, and outcomes changed over time has not been investigated. OBJECTIVES The purpose of this study was to assess temporal trends in SrSCA incidence, management, and survival. METHODS Using data from the French National Institute of Health and Medical Research, we evaluated the evolution of incidence, prehospital management, and survival at hospital discharge of SrSCA among subjects aged 18 to 75 years, over 6 successive 2-year periods between 2005 and 2018. RESULTS Among the 377 SrSCA, 20 occurred in young competitive athletes (5.3%), whereas 94.7% occurred in middle-aged recreational sports participants. Comparing the last 2-year to the first 2-year period, SrSCA incidence remained stable (6.24 vs 7.00 per million inhabitants/y; P = 0.51), with no significant differences in patients' mean age (46.6 +/- 13.8 years vs 51.0 +/- 16.4 years; P = 0.42), sex (men 94.7% vs 95.2%; P = 0.99), and history of heart disease (12.5% vs 15.9%; P = 0.85). However, frequency of bystander cardiopulmonary resuscitation and public automated external defibrillator use increased significantly (34.9% vs 94.7%; P < 0.001 and 1.6% vs 28.8%; P = 0.006, respectively). Survival to hospital discharge improved steadily, reaching 66.7% in the last study period compared with 23.8% in the first (P < 0.001). CONCLUSIONS Incidence of SrSCA remained relatively stable over time, suggesting a need for improvement in screening strategies. However, major improvements in on-field resuscitation led to a 3-fold increase in survival, underlining the value of public education in basic life support that should serve as an example for SCA in general. (C) 2022 by the American College of Cardiology Foundation.
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