Department of Emergency Medicine, Singapore General Hospital, Singapore.
Ann Acad Med Singap. 2010 Jul;39(7):542-6.
Exercise-related cardiac arrest is uncommon, however it is devastating when it occurs in otherwise healthy adults. This study aims to identify the characteristics of exercise-related cardiac arrest in the study population and estimate the overall survival rate.
This is a retrospective observational study of exercise-related cardiac arrest in Singapore. Patients with exercise-related out of hospital cardiac arrest (OHCA) were selected from the Cardiac Arrest and Resuscitation Epidemiology (CARE) database, which is a prospective cardiac arrest registry, derived from ambulance records, emergency department and hospital discharge records. Patient characteristics, cardiac arrest circumstances and outcomes were studied.
Fifty-fi ve cases of exercise-related cardiac arrests were identified from December 2001 to January 2008. Mean age was 50.9 years with a male predominance of 96.4%. Eighty percent of the exercise-related cardiac arrests were witnessed, however only 58.2% of the patients received bystander cardiopulmonary resuscitation (CPR). The fi rst presenting rhythm was ventricular fibrillation (VF) in 40% of the patients, followed by asystole (38.2%). Of 96.2% of the patients who died from cardiac causes, coronary artery disease was the main etiology for 54%. The 30-day survival rate was 5.5%.
We found that exercise-related cardiac arrest causes significant mortality in our community. Increased CPR training among the public, easy access to defibrillators and faster emergency medical service (EMS) response time could improve the outcome of exercise-related cardiac arrests. A comprehensive pre-participation screening for competitive exercises should be outlined for primary prevention of exercise-related cardiac arrest. A better reporting system for exercise-related cardiac arrest is needed.
运动相关性心搏骤停较为少见，但在健康成年人中发生时后果却非常严重。本研究旨在确定研究人群中心搏骤停与运动的相关性特征，并估计总体存活率。
这是一项对新加坡运动相关性院外心搏骤停（OHCA）的回顾性观察性研究。从心脏骤停和复苏流行病学（CARE）数据库中选择运动相关性 OHCA 患者，该数据库是一个前瞻性的心脏骤停登记处，源自救护车记录、急诊部和医院出院记录。研究了患者特征、心脏骤停情况和结局。
2001 年 12 月至 2008 年 1 月期间共发现 55 例运动相关性心搏骤停。平均年龄为 50.9 岁，男性占 96.4%。80%的运动相关性心搏骤停有目击者，但只有 58.2%的患者接受了旁观者心肺复苏（CPR）。40%的患者首次出现的节律为室颤（VF），其次是心搏停止（38.2%）。96.2%死于心源性原因的患者中，54%的主要病因是冠状动脉疾病。30 天存活率为 5.5%。
我们发现运动相关性心搏骤停在我们的社区中导致了显著的死亡率。提高公众的 CPR 培训水平、方便获取除颤器以及加快紧急医疗服务（EMS）响应时间可以改善运动相关性心搏骤停的结局。应制定全面的竞争性运动前筛查方案，以预防运动相关性心搏骤停。需要建立一个更好的运动相关性心搏骤停报告系统。
