Does occurrence during sports affect sudden cardiac arrest survival?

RESUSCITATION

卷:141

Article

Pechmajou, Louis^1,2,3  Sharifzadehgan, Ardalan^1,2,3  Bougouin, Wulfran^1,2  Dumas, Florence^1,2,4  Beganton, Frankie¹  Jost, Daniel^1,5  Lamhaut, Lionel^1,2,6  Lecarpentier, Eric⁷  Loeb, Thomas⁸  Adnet, Frederic⁹  Agostinucci, Jean-Marc⁹  Narayanan, Kumar^1,10  Sideris, Georgios¹¹  Voicu, Sebastian¹²  Cariou, Alain^1,2,13  Spaulding, Christian^1,2,3  Marijon, Eloi^1,2,3  Jouven, Xavier^1,2,3  Karam, Nicole^1,2,3 

[1] INSERM, Unit 970, Paris Cardiovasc Res Ctr, Paris Sudden Death Expertise Ctr Paris SDEC, Paris, France

[2] Paris Descartes Univ, Paris, France

[3] Hop Europeen Georges Pompidou, Cardiol Dept, 20-40 Rue Leblanc, F-75908 Paris 15, France

[4] Cochin Hosp, Emergency Dept, Paris, France

[5] Paris Firefighters Brigade, Paris, France

[6] Hop Necker Enfants Malad, Emergency Med Serv SAMU 75, Paris, France

[7] Henri Mondor Hosp, Emergency Med Serv SAMU 94, Creteil, France

[8] Hop Raymond Poincare, Emergency Med Serv SAMU 92, Garches, France

[9] Avicenne Hosp, Emergency Med Serv SAMU 93, Bobigny, France

[10] Maxcure Hosp, Cardiol Dept, Hyderabad, India

[11] Lariboisiere Hosp, Cardiol Dept, Paris, France

[12] Lariboisiere Hosp, Intens Care Unit, Paris, France

[13] Cochin Hosp, Intens Care Unit, Paris, France

关键词: Sudden death;    Exercise;    Screening;    Prevention;    Education;   

DOI  :  10.1016/j.resuscitation.2019.06.277

来源: Elsevier

【 摘 要 】

Objectives: A higher survival rate was observed in Sudden Cardiac Arrest (SCA) occurring during sports activities, although the underlying mechanisms remain unclear. We tested the hypothesis that better initial management, rather than sports per se, may account for the observed better outcomes during sports activities. Methods: Data was taken between May 2011 and March 2016 from a prospective ongoing registry that includes all SCA in Paris and suburbs (6.7 million inhabitants). Sports-related SCA (i.e. SCA occurring during sport activities or within one hour of cessation of the activity) were identified. Results: Over the study period, 13,400 SCA occurred, of which 154 were sports-related (median age: 51.2 years, 96.1% males). At discharge, sports activity was associated with an 8-times higher survival rate (39.7% vs. 5.1%, P < 0.001). Logistic regression showed that after considering potential confounders, including age, gender, SCA location, witness presence, time to response, and initial shockable rhythm, occurrence of SCA during sports was associated with a higher survival rate (OR 1.77, 95% CI 1.14-2.74, P = 0.01). However, after further adjustment for initial basic life support, i.e. bystander CPR and AED use, there was no association between sports setting and survival at hospital discharge (OR 1.43, 95% CI 0.91-2.23, P = 0.12). Conclusion: Sports-related SCA is a rare event, with an 8-times higher survival rate compared to non-sports-related SCA. Better initial management, including bystander CPR and AED use, rather than sports per se, mainly accounts this difference. This highlights the major importance of population education to basic life support in improving SCA outcome.

【 授权许可】

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