Survival trends in the United States following exercise-related sudden cardiac arrest in the youth: 2000-2006.

BACKGROUND Sudden cardiac arrest is the leading cause of death in young athletes. However, limited studies have examined survival rates after exercise-related sudden cardiac arrest in the youth. OBJECTIVE The Purpose of this study was to monitor exercise-related sudden death in the United States and to assess survival trends following exercise-related sudden cardiac arrest in the youth. METHODS From January 1, 2000, through December 31, 2006, exercise-related sudden death events in young individuals were identified through a systematic search of public media reports. Media reports were reviewed to clarify case circumstances and relation to exercise, cause of death, outcome, and use of a defibrillator. The study used an observational cohort design with weekly searches and updates to the database. RESULTS During the 7-year period from 2000-2006, 486 total cases of exercise-related sudden cardiac arrest were identified in elementary school (age 5-11 years), middle school (age 11-14 years), high school (age 14-18 years), and college (age 18-22 years) individuals in the United States, with an average of 69 cases per year (range 48-96 years). Eighty-three percent (405/486) of victims were male and 17% (81/486) were female, with a male-to-female ratio of 5:1. Overall survival during this time period was 11% (55/486), with a range of 4% to 21% survival per year. There was a statistically significant trend toward improved survival in recent years (P = .035). Females were more likely to survive sudden cardiac arrest than were males (21% vs 9%, P = .001). CONCLUSION Survival following exercise-related sudden cardiac arrest in the youth has been universally poor over the last 7 years in the United States, despite a recent trend toward improved survival. Improved reporting systems are needed to accurately monitor these events, and strategies to improve outcomes from exercise-related sudden cardiac arrest in the youth, such as improved emergency response planning and public access defibrillation programs, should be considered.