Stokstad Magnus Thue, Berge Hilde Moseby, Gjesdal Knut
Tidsskr Nor Laegeforen. 2013 Sep 3;133(16):1722-5. doi: 10.4045/tidsskr.13.0016.
Young athletes are at an increased risk of sudden cardiac death compared to others. Cardiac screening has been proposed to prevent deaths. We wished to review the evidence for cardiac screening of young athletes.
We have conducted a literature search in PubMed on sudden cardiac death in young athletes, using a combination of search terms related to screening, incidence, cost efficiency and recommendations, supplemented by secondary references and articles from our own archive.
Published studies utilise a variety of definitions of athlete and sudden death, and some studies also include cardiac arrest with subsequent successful resuscitation. Retrospective studies, often based on media searches, remain the most common form. The cause of death is not invariably determined by an autopsy. Recommendations in favour of screening are based on studies of limited quality and on the personal, often regional, experiences of experts.
The differences in study methods result in uncertain incidence figures. The estimates of cost efficiency are therefore questionable. To improve the quality of knowledge, standardised methods need to be devised, ideally also including a register of cardiac arrest in children and young people. To date, we have insufficient knowledge to recommend mandatory cardiac screening with ECG in Norway. Should this be introduced, it should be differentiated according to gender, type of sport and competition level. Cost efficiency could probably be improved with the aid of standardised questionnaires and a standardised interpretation of ECG among athletes.
与其他人相比，年轻运动员发生心源性猝死的风险更高。有人提议进行心脏筛查以预防死亡。我们希望回顾一下对年轻运动员进行心脏筛查的证据。
我们在PubMed上搜索了关于年轻运动员心源性猝死的文献，使用了与筛查、发病率、成本效益和建议相关的搜索词组合，并辅以二次参考文献和我们自己存档中的文章。
已发表的研究使用了多种运动员和猝死的定义，一些研究还包括心脏骤停后成功复苏的情况。回顾性研究，通常基于媒体搜索，仍然是最常见的形式。死亡原因并非总是通过尸检确定。支持筛查的建议基于质量有限的研究以及专家的个人（通常是地区性）经验。
研究方法的差异导致发病率数据不确定。因此，成本效益的估计值得怀疑。为了提高知识质量，需要设计标准化方法，理想情况下还应包括儿童和年轻人心脏骤停登记册。迄今为止，我们没有足够的知识来推荐在挪威对运动员进行强制性心电图心脏筛查。如果引入这种筛查，应该根据性别、运动类型和比赛水平进行区分。借助标准化问卷和对运动员心电图的标准化解读，成本效益可能会得到提高。
