Abstract
Objective
To determine the incidence and etiology of sudden cardiac arrest and death (SCA/D)
in US high school athletes.
Patients and Methods
A prospective media database of SCA/D was queried for cases aged 14 to 18 years from
7 states over 6 school years (September 1, 2007, to August 30, 2013). Event details
were investigated to determine participation on a high school athletic team, sex,
sport, and occurrence during school-sponsored activity or exertion. National sports
participation numbers were used and a conversion factor was applied to account for
multisport athletes. Autopsy reports were reviewed and cause of death was adjudicated
by an expert panel.
Results
A total of 16,390,409 million athlete-seasons representing 6,974,640 athlete-years
(AY) were examined, encompassing 36% of the total US high school athlete population.
A total of 104 cases of SCA/D were identified (35 SCA with survival and 69 sudden
cardiac deaths [SCDs]). The rate of SCD was 1:101,082 AY and of SCA/D 1:67,064 AY.
Eighty-eight percent (92) of events occurred in male athletes. The rate of SCA/D in
male athletes was 1:44,832 AY and in female athletes 1:237,510 AY (incidence rate
ratio, 5.3; 95% CI, 2.9-10.6; P<.001). Men's basketball was the highest risk sport with an SCA/D incidence of 1:37,087
AY followed by men's football at 1:86,494 AY. Men's basketball and football athletes
accounted for 57% (39) of deaths. Eighty percent of SCDs (55 of 69) were exertional
and 55% (38 of 69) occurred while playing for a school-sponsored team. Autopsy reports
were obtained in 73% (50) of cases. The most common findings of autopsy were idiopathic
left ventricular hypertrophy or possible cardiomyopathy (13 of 50 [26%]), autopsy-negative
sudden unexplained death (9 of 50 [18%]), hypertrophic cardiomyopathy (7 of 50 [14%]),
and myocarditis (7 of 50 [14%]).
Conclusion
The rate of SCA/D in male high school athletes was 1:44,832 AY, with almost half due
to possible or confirmed cardiomyopathy disease. It is likely that many cases were
not identified because of reliance on media reports, and these numbers represent a
minimum estimate.
Abbreviations and Acronyms:
AED (automated external defibrillator), AY (athlete-year), CAA (coronary artery abnormality), HCM (hypertrophic cardiomyopathy), LVH (left ventricular hypertrophy), NFHS (National Federation of State High School Associations), PPE (preparticipation examination), SCA (sudden cardiac arrest), SCA/D (sudden cardiac arrest/death), SCD (sudden cardiac death)To read this article in full you will need to make a payment
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Article Info
Publication History
Published online: September 28, 2016
Footnotes
For editorial comment, see page 1489; for related articles, see pages 1503, 1606, and 1617
Grant Support: This work was supported by award KL2TR000421 (D.S.O.) from the National Center for Advancing Translational Sciences of the National Institutes of Health.
Potential Competing Interests: Dr Prutkin has received grants from Boston Scientific and St. Jude Medical. Dr Ackerman is a consultant to Boston Scientific, Gilead Sciences, Medtronic, and St. Jude Medical and receives royalties from Transgenomic.
Identification
Copyright
© 2016 Mayo Foundation for Medical Education and Research
