Abstract 3872: Profile and Frequency of Sudden Deaths in 1,463 Young Competitive Athletes: From a 25-year U.S. National Registry, 1980–2005
Introduction. Sudden deaths (SD) in young competitive athletes have become highly visible events of intense and growing interest to both the physician and lay communities. However, the magnitude of this clinical problem is unresolved, as previous estimates place the frequency at only 10–20 deaths/year, suggesting that such catastrophes could represent a relatively unimportant public health issue.
Methods. We have assembled and accessed a national Sudden Death in Young Athletes Registry which has prospectively and retrospectively identified SDs in competitive athletes from a variety of sources including search engines, LexisNexis database, and informal contacts, and then tracked these events in all 50 states to acquire demographic and autopsy data.
Results. A total of 1,463 athletes who died suddenly (1980–2005) constitute the study group, age 17.5±5 years; 90% male; 35% African-American; and 60% in high school. The maximum number of SD in a given year was 100 (in 2001), with the average over the last 5 years = 90/year. Deaths were uncommonly reported in the 1980s and have increased over the 25 years, 476 during 1980–1992 (32% of total) and 987 during 1993–2005 (68%) (p = <0.001). Of the 1,463 deaths, 71% occurred during actual competition or training in 35 diverse sports, with football (n = 509) and basketball (n = 356) most common, and comprising 60% of all deaths. Causes of SD were predominantly due to confirmed or suspected cardiovascular disease (69%), but also blunt trauma (16%), commotio cordis (6%), heat stroke (3%) and drugs (2%). The most common of the cardiovascular causes were hypertrophic cardiomyopathy (HCM) (36%), coronary artery anomalies (17%) and myocarditis (6%). Of those athletes dying of HCM, most (52%) were African-American and only 3% were female. SDs were most commonly reported from California (n = 135), Texas (n = 93) and Florida (n = 81).
Conclusions. The frequency of SD in young U.S. athletes has been underestimated and is 5 to 10-fold more common than previously regarded with an incidence of at least 100/year, or about one sudden death every 3 days. These deaths occurred disproportionately in African-Americans and were particularly uncommon in female athletes. HCM continues to be the most common cardiovascular cause of SD in young athletes.