Sudden Cardiac Arrest during Participation in Competitive Sports.
Sudden Cardiac Arrest during Participation in Competitive Sports.
复制标题
DOI：
10.1056/nejmoa1615710
复制
发表时间：
2017-11-16
期刊：
影响因子：
--
通讯作者：
Rescu Investigators
中科院分区：
文献类型：
--
作者：
Landry CH;Allan KS;Connelly KA;Cunningham K;Morrison LJ;Dorian P;Rescu Investigators
参与体育活动时心脏骤停的发生率尚不清楚。旨在预防体育活动期间心脏骤停的赛前筛查项目被认为能够识别有风险的运动员；然而，这些计划的有效性仍然存在争议。我们试图确定在加拿大特定地区参加体育活动时发生的所有心脏骤停，并确定其原因。在这项回顾性研究中，我们使用Rescu epstry心脏骤停数据库（其中包含网络区域护理人员参与的每一次心脏骤停的记录）来确定2009年至2014年12至45岁的人在参加体育运动期间发生的所有院外心脏骤停。根据多种来源的记录，包括救护车呼叫报告、尸检报告、住院数据以及与患者或家属的直接访谈记录，将病例判定为心脏骤停（即心脏原因）或由非心脏原因引起的事件。在1850万人年的观察过程中，74例心脏骤停发生在参加体育运动期间；其中16例发生在竞技体育运动中，58例发生在非竞技体育运动中。竞技运动中心脏骤停的发生率为每10万运动员年0.76例，43.8%的运动员存活至出院。在竞技运动员中，2例死亡归因于肥厚性心肌病，无一例死亡归因于致心律失常性右室心肌病。在参加竞技运动期间发生的三例心脏骤停，如果运动员进行了赛前筛查，则确定有潜在的可识别性。在我们对院外心脏骤停患者的研究中，参加竞技体育期间心脏骤停的发生率为每10万运动员年0.76例。结构性心脏病引起的心脏骤停在竞技体育中并不常见。（由国家心脏、肺和血液研究所等机构资助。）
The incidence of sudden cardiac arrest during participation in sports activities remains unknown. Preparticipation screening programs aimed at preventing sudden cardiac arrest during sports activities are thought to be able to identify at-risk athletes; however, the efficacy of these programs remains controversial. We sought to identify all sudden cardiac arrests that occurred during participation in sports activities within a specific region of Canada and to determine their causes. In this retrospective study, we used the Rescu Epistry cardiac arrest database (which contains records of every cardiac arrest attended by paramedics in the network region) to identify all out-of-hospital cardiac arrests that occurred from 2009 through 2014 in persons 12 to 45 years of age during participation in a sport. Cases were adjudicated as sudden cardiac arrest (i.e., having a cardiac cause) or as an event resulting from a noncardiac cause, on the basis of records from multiple sources, including ambulance call reports, autopsy reports, in-hospital data, and records of direct interviews with patients or family members. Over the course of 18.5 million person-years of observation, 74 sudden cardiac arrests occurred during participation in a sport; of these, 16 occurred during competitive sports and 58 occurred during noncompetitive sports. The incidence of sudden cardiac arrest during competitive sports was 0.76 cases per 100,000 athlete-years, with 43.8% of the athletes surviving until they were discharged from the hospital. Among the competitive athletes, two deaths were attributed to hypertrophic cardiomyopathy and none to arrhythmogenic right ventricular cardiomyopathy. Three cases of sudden cardiac arrest that occurred during participation in competitive sports were determined to have been potentially identifiable if the athletes had undergone preparticipation screening. In our study involving persons who had out-of-hospital cardiac arrest, the incidence of sudden cardiac arrest during participation in competitive sports was 0.76 cases per 100,000 athlete-years. The occurrence of sudden cardiac arrest due to structural heart disease was uncommon during participation in competitive sports. (Funded by the National Heart, Lung, and Blood Institute and others.)