Harmon Kimberly G, Asif Irfan M, Maleszewski Joseph J, Owens David S, Prutkin Jordan M, Salerno Jack C, Zigman Monica L, Ellenbogen Rachel, Rao Ashwin L, Ackerman Michael J, Drezner Jonathan A
From University of Washington, Seattle (K.G.H., D.S.O., J.M.P., J.C.S., M.L.Z., A.L.R., J.A.D.); University of South Carolina Greenville (I.M.A.); Mayo Clinic, Rochester, MN (J.J.M., M.J.A.); and Brown University, Providence, RI (R.E.).
Circulation. 2015 Jul 7;132(1):10-9. doi: 10.1161/CIRCULATIONAHA.115.015431. Epub 2015 May 14.
The incidence and cause of sudden cardiac death (SCD) in athletes is debated with hypertrophic cardiomyopathy often reported as the most common cause.
A database of all National Collegiate Athletic Association deaths (2003-2013) was developed. Additional information and autopsy reports were obtained when possible. Cause of death was adjudicated by an expert panel. There were 4 242 519 athlete-years (AY) and 514 total student athlete deaths. Accidents were the most common cause of death (257, 50%, 1:16 508 AY) followed by medical causes (147, 29%, 1:28 861 AY). The most common medical cause of death was SCD (79, 15%, 1:53 703 AY). Males were at higher risk than females 1:37 790 AY versus 1:121 593 AY (incidence rate ratio, 3.2; 95% confidence interval, 1.9-5.5; P<0.00001), and black athletes were at higher risk than white athletes 1:21491 AY versus 1:68 354 AY (incidence rate ratio, 3.2; 95% confidence interval, 1.9-5.2; P<0.00001). The incidence of SCD in Division 1 male basketball athletes was 1:5200 AY. The most common findings at autopsy were autopsy-negative sudden unexplained death in 16 (25%), and definitive evidence for hypertrophic cardiomyopathy was seen in 5 (8%). Media reports identified more deaths in higher divisions (87%, 61%, and 44%), whereas the percentages from the internal database did not vary (87%, 83%, and 89%). Insurance claims identified only 11% of SCDs.
The rate of SCD in National Collegiate Athletic Association athletes is high, with males, black athletes, and basketball players at substantially higher risk. The most common finding at autopsy is autopsy-negative sudden unexplained death. Media reports are more likely to capture high-profile deaths, and insurance claims are not a reliable method for case identification.
运动员心源性猝死（SCD）的发病率及病因存在争议，肥厚型心肌病常被报道为最常见病因。
建立了一个涵盖所有美国大学体育协会死亡案例（2003 - 2013年）的数据库。尽可能获取了更多信息及尸检报告。死亡原因由一个专家小组判定。共有4242519运动员年（AY），学生运动员总死亡人数为514人。意外事故是最常见的死亡原因（257例，50%，1:16508 AY），其次是医学原因（147例，29%，1:28861 AY）。最常见的医学死亡原因是SCD（79例，15%，1:53703 AY）。男性风险高于女性，分别为1:37790 AY和1:121593 AY（发病率比，3.2；95%置信区间，1.9 - 5.5；P<0.00001），黑人运动员风险高于白人运动员，分别为1:21491 AY和1:68354 AY（发病率比，3.2；95%置信区间，1.9 - 5.2；P<0.00001）。一级男子篮球运动员中SCD的发病率为1:5200 AY。尸检时最常见的发现是16例（25%）尸检阴性的不明原因猝死，5例（8%）有肥厚型心肌病的确切证据。媒体报道显示高级别赛事中的死亡人数更多（87%、61%和44%），而内部数据库中的百分比并无差异（87%、83%和89%）。保险理赔仅识别出11%的SCD病例。
美国大学体育协会运动员中SCD的发生率很高（1:53703 AY），男性、黑人运动员和篮球运动员的风险显著更高。尸检时最常见的发现是尸检阴性的不明原因猝死。媒体报道更有可能捕捉到备受瞩目的死亡事件，而保险理赔并非识别病例的可靠方法。
