Fewer sports related sudden cardiac arrest victims die nowadays, a trend link with increase bystander cardiopulmonary resuscitation (CPR), reports a study presented today at ESC Congress 2019 together with the World Congress of Cardiology. The late breaking study also found that the incidence of sudden cardiac arrest during sports has not change over the last decade.
Sudden cardiac arrest is lethal within minutes if left untreat and rapid initiation of CPR improves survival. Pre-participation screening of athletes aims to identify those at high risk and potentially exclude them from sports; with the ultimate goal of reducing the incidence of sudden cardiac arrest. In most cases, decisions on who to screen are made by international sporting bodies; so rather than national healthcare systems.
“In our study, bystander CPR was with a nearly eight times greater likelihood; which of sudden cardiac arrest victims surviving to hospital discharge,” said principal investigator Professor Xavier Jouven of the Paris-Sudden Death Expertise Centre. “Failure to reduce the incidence of sports relate sudden cardiac arrest is disappointing; also questions the efficacy of screening programmes.”
Prof Jouven said: “This study was done to assess trends in incidence and survival of sports relate sudden cardiac arrest. They initially expect both a decrease in incidence due to screening programmes; also an increase in survival due to CPR.” The analysis was conduct using two prospective registries carry out by the Paris-Sudden Death Expertise Centre. All sudden cardiac arrests occurring during or immediately after competitive and amateur sports in Paris; also the surrounding suburbs were record in 2005 to 2010 and 2011 to 2016.
Overall burden of death
Survival rates to hospital admission and discharge were significantly higher in the later period. In 2011 to 2016, 85% of patients survive to hospital admission compare to the 51% in 2005 to 2010. The corresponding rates of survival to hospital discharge were 43% versus 26%, respectively. In-hospital mortality remain stable at around 51%. The overall burden of death due to sports relate sudden cardiac arrest; which decrease from 4.3 to 3.4 deaths per million inhabitants per year.
In multivariable analysis, the only factors independently with increase survival to hospital discharge were shockable rhythm (odds ratio 6.82; 95% confidence interval [CI] 2.77-19.80; p<0.001) and bystander CPR. Prof Jouven said: “They observe an important decrease in deaths due to sudden cardiac arrest during sports over a 12-year period which was relate to more frequent CPR. The static incidence is probably cause by difficulties in early identification of individuals at high risk for sudden cardiac arrest during sports.”
“To further improve survival from cardiac arrest, CPR should be taught to the general public and particularly to sports medicine practitioners,” said Prof Jouven. “An AED should be available in all sports venues. Preventing sudden cardiac arrest remains the ideal goal in the future, smartwatches and internet connect T-shirts may alert us to warning signs occurring minutes or hours before; so allowing early resuscitation and prevention.”