Incidence of Sudden Cardiac Death in National Collegiate Athletic Association Athletes

Study Questions:

What is the true incidence of sudden cardiac death (SCD) in National Collegiate Athletic Association (NCAA) student-athletes?


From January 2004 through December 2008, all cases of sudden death in NCAA student-athletes were identified by use of an NCAA database, weekly systematic search of public media reports, and catastrophic insurance claims.


During the 5-year period, there were 273 deaths and a total of 1,969,663 athlete participant-years. Of these 273 deaths, 187 (68%) were due to nonmedical or traumatic causes, 80 (29%) to medical causes, and 6 (2%) to unknown causes. Cardiovascular-related sudden death was the leading cause of death in 45 (56%) of 80 medical cases, and represented 75% of sudden deaths during exertion. The incidence of SCD was 1:43,770 participants per year. Among NCAA Division I male basketball players, the rate of SCD was 1:3100 per year. Of the 45 cardiac cases, 39 (87%) were identified in the NCAA database; only 25 (56%) were identified by the use of public media reports, and only 9 (20%) were identified from catastrophic claims data.


SCD is the leading medical cause of death and death during exercise in NCAA student-athletes. Current methods of data collection underestimate the risk of SCD. Accurate assessment of SCD incidence is necessary to shape appropriate health policy decisions and develop effective strategies for prevention.


The true incidence of SCD in US athletes is unknown. Current estimates are based largely on case identification through public media reports and estimated participation rates in athletics. This study suggests that the rate of SCD in US athletes might be higher than previous estimates. This has implications in policy decisions regarding how athletes should be screened: Relatively higher rates of SCD among athletes could favor policies that encourage (or mandate) progressively more rigorous screening procedures.

Clinical Topics: Arrhythmias and Clinical EP, Diabetes and Cardiometabolic Disease, Prevention, Sports and Exercise Cardiology, SCD/Ventricular Arrhythmias, Exercise

Keywords: Athletes, Cause of Death, Students, Incidence, Exercise, Sports, Death, Sudden, Cardiac

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