Survival from Sports-Related Sudden Cardiac Arrest: In Sports Facilities versus Outside of Sports Facilities Running Title: Sports-Related Sudden Cardiac Arrest
Résumé
Background – We sought to evaluate frequency, characteristics and outcomes ofsudden cardiac arrest (SCA) during sports activities according to the location ofoccurrence (in sports facilities versus those occurring outside of sports facilities).Methods and Results – Observational 5-year prospective national French survey ofsubjects 10-75 years old presenting with SCA during sports (2005–2010), in 60 Frenchadministrative regions (covering a population of 35 million people). Of the 820 SCAduring sports, 426 SCA (52%) occurred in sports facilities. Overall, a substantially highersurvival rate at hospital discharge was observed among SCA in sports facilities (22.8%,95% CI 18.8–26.8) compared to those occurring outside (8.0%, 95% CI 5.3–10.7)(P<0.0001). Patients with SCA in a sports facility were younger (42.1 vs. 51.3 years,P<0.0001) and less frequently had known cardiovascular diseases (P<0.0001). Theevents were more often witnessed (99.8% vs. 84.9%, P<0.001) and bystandercardiopulmonary resuscitation more frequently initiated (35.4% vs. 25.9%, P=0.003).Delays of intervention were significantly shorter when SCA occured in sports facilities(9.3 vs. 13.2 minutes, P=0.02) and the proportion in initially shockable rhythm washigher (58.8% vs. 33.1%, P<0.0001). Better survival in sport facilities was mainlyexplained by concomitant circumstances of occurrence (adjusted OR 1.48, 95%CI 0.88–2.49, P=0.134).Conclusions – Sports-related SCA is not a homogeneous entity. The three-fold highersurvival rate reported among sports-related SCA is mainly due to cases which occur insport facilities, whereas SCA during sport occurring outside of sports facilities suffersfrom the usual very low rate of survival.