Original Investigation
Evolution of Incidence, Management, and Outcomes Over Time in Sports-Related Sudden Cardiac Arrest

https://doi.org/10.1016/j.jacc.2021.11.011Get rights and content
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Abstract

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.

Key Words

basic life support
prevention
resuscitation
sports
sudden death
temporal trends

Abbreviations and Acronyms

AED
automated external defibrillation
BLS
basic life support
CPR
early cardiopulmonary resuscitation
SCA
sudden cardiac arrest
SrSCA
sports-related sudden cardiac arrest

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The authors attest they are in compliance with human studies committees and animal welfare regulations of the authors’ institutions and Food and Drug Administration guidelines, including patient consent where appropriate. For more information, visit the Author Center.

Drs Jouven and Marijon contributed equally to this work. For a full list of the 2021 Paris-Sudden Death Expertise Center Investigators, please see the Supplemental Appendix.