Sports-Related Sudden Death in the General Population
How often does sudden death (SD) occur during recreational sports?
This prospective 5-year observational study was conducted in France in subjects 10-75 years old. Sports-related SD was defined as death or aborted SD during or within 1 hour of sports activity. Cases were detected through the emergency response system and by web-based media search.
A total of 820 sports-related SDs occurred during the 5-year study period, yielding an estimated incidence of 4.6 per million population per year. The incidence was much higher in males (32.8/million/year) than females (1.9/million/year). The mean age at the time of SD was 46 years. SD occurred in a public sports facility in 52% of cases, and 99.8% of these were witnessed. Eighty-three percent of SDs that occurred outside a sports facility were witnessed. Bystander cardiopulmonary resuscitation (CPR) was performed in 31% of cases. Survival to hospital admission was 30.8%, and survival to hospital discharge was 15.7%. Independent predictors of survival to hospital discharge were bystander CPR (odds ratio [OR], 3.7), time to start of CPR (OR, 1.3), and the initial use of a defibrillator (OR, 3.7). A cause of SD was identified in 25% of cases. The most common etiology was coronary artery disease (75%). Other etiologies (each <5%) included hypertrophic cardiomyopathy, dilated cardiomyopathy, right ventricular dysplasia, Wolff-Parkinson-White syndrome, and commotio cordis.
Despite the fact that most sports-related SDs in the general population are witnessed, bystander CPR is performed in only approximately one-third of cases.
It is likely that survival after sports-related cardiac arrest could be significantly improved by more extensive public education on bystander CPR and by greater availability of automatic external defibrillators in public sports facilities.
Keywords: Incidence, France, Cardiopulmonary Resuscitation, Sports, Heart Arrest, Death, Sudden, Cardiac
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