Major regional disparities in outcomes after sudden cardiac arrest during sports.

Abstract:

AIMS:Characteristics of sudden cardiac arrest (SCA) during sports offers a novel (and unexplored) setting to assess factors associated with disparities in outcomes across regions. METHODS AND RESULTS:From a prospective 5-year community-based French registry concerning SCA during sports in 10-75 year-olds, we evaluated whether outcomes differed significantly between geographic regions. We then determined the extent to which variations in community-related early interventions were associated with regional variations in survival. Among 820 SCA cases studied, overall survival at hospital discharge was 15.7% (95% confidence interval, 13.2-18.2%), with considerable regional disparities (from 3.4 to 42.6%, P < 0.001). Major differences were noted regarding bystander initiation of cardiopulmonary resuscitation (15.3-80.9%, P < 0.001) and presence of initial shockable rhythm (28.6-79.1%, P < 0.001), with higher values of these being associated with better survival rates. The proportion of survivors with favourable neurological outcome at discharge was fairly uniform among survival groups (CPC-1/2, varying from 77.4 to 90.0%, P = 0.83). No difference was observed regarding subjects' characteristics and circumstances of SCA occurrence, including delays in resuscitation (collapse-to-call period). With a comparable in-hospital mortality (P = 0.44), survival at hospital discharge was highly correlated with that at hospital admission (regional variations from 7.4 to 75.0%, P < 0.001). CONCLUSION:Major regional disparities exist in survival rates (up to 10-fold) after SCA during sports. SCA cases from regions with the highest levels of bystander resuscitation had the best survival rates to hospital admission and discharge.

journal_name

Eur Heart J

journal_title

European heart journal

authors

Marijon E,Bougouin W,Celermajer DS,Perier MC,Benameur N,Lamhaut L,Karam N,Dumas F,Tafflet M,Prugger C,Mustafic H,Rifler JP,Desnos M,Le Heuzey JY,Spaulding CM,Avillach P,Cariou A,Empana JP,Jouven X

doi

10.1093/eurheartj/eht282

subject

Has Abstract

pub_date

2013-12-01 00:00:00

pages

3632-40

issue

47

eissn

0195-668X

issn

1522-9645

pii

eht282

journal_volume

34

pub_type

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