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

نویسندگان

  • Eloi Marijon
  • Wulfran Bougouin
  • David S Celermajer
  • Marie-Cécile Perier
  • Nordine Benameur
  • Lionel Lamhaut
  • Nicole Karam
  • Florence Dumas
  • Muriel Tafflet
  • Christof Prugger
  • Hazrije Mustafic
  • Jean-Pierre Rifler
  • Michel Desnos
  • Jean-Yves Le Heuzey
  • Christian M Spaulding
  • Paul Avillach
  • Alain Cariou
  • Jean-Philippe Empana
  • Xavier Jouven
چکیده

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.

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عنوان ژورنال:
  • European heart journal

دوره 34 47  شماره 

صفحات  -

تاریخ انتشار 2013