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

• Published in: Journal of the American College of Cardiology Vol. 79; no. 3; pp. 238 - 246
• Main Authors: Karam, Nicole, Pechmajou, Louis, Narayanan, Kumar, Bougouin, Wulfran, Sharifzadehgan, Ardalan, Anys, Soraya, Weizman, Orianne, Perrot, David, Waldmann, Victor, Beganton, Frankie, Perier, Marie-Cécile, Rischard, Julien, Loeb, Thomas, Agostinucci, Jean-Marc, Lecarpentier, Eric, Jabre, Patricia, Jost, Daniel, Dumas, Florence, Cariou, Alain, Jouven, Xavier, Marijon, Eloi
• Format: Journal Article
• Language: English
• Published: United States 25.01.2022
• Subjects: Age Distribution; Athletes; Cardiopulmonary Resuscitation - statistics & numerical data; Datasets as Topic; Death, Sudden, Cardiac - epidemiology; Defibrillators - supply & distribution; Female; France - epidemiology; Humans; Incidence; Male; Middle Aged; Sex Distribution; Survival Analysis; France; sudden death; resuscitation; sports; temporal trends; prevention; basic life support
• ISSN: 0735-1097; 1558-3597
• DOI: 10.1016/j.jacc.2021.11.011

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. The purpose of this study was to assess temporal trends in SrSCA incidence, management, and survival. 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. 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). 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.