Abstract 16173: Major Regional Disparities in Outcomes After Sudden Cardiac Death During Sports
Background: Characteristics of sudden cardiac death (SCD) during sports offers a novel (and unexplored) setting to assess factors associated with disparities in outcomes across regions.
Hypothesis: There are major regional disparities in survival after SCD during sports.
Methods: 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.
Results: Among 820 SCA cases studied, overall survival at hospital discharge was 15.7% (95% CI, 27.7% to 34.0%), with considerable regional disparities (from 4.3% to 42.7%, P<0.001). Major differences were noted regarding bystander initiation of cardiopulmonary resuscitation (15.3% to 80.9%, P<0.001) and presence of initial shockable rhythm (28.6% to 79.1%, P<0.001), with higher values of these being associated with better survival rates. The proportion of survivors with favorable neurologic 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 SCD occurrence, including delays in resuscitation (collapse-to-call period) and public use of defibrillation. With a comparable in-hospital mortality (P=0.59), survival at hospital discharge was highly correlated with survival at hospital admission (regional variations from 7.4% to 75.0%, P<0.001).
Conclusion: Major regional disparities exist in survival rates (up to ten-fold) after SCD during sports. SCD cases from regions with the highest levels of bystander resuscitation had the best survival rates to hospital admission and discharge.
- © 2013 by American Heart Association, Inc.