Marijon Eloi, Bougouin Wulfran, Karam Nicole, Beganton Frankie, Lamhaut Lionel, Perier Marie-Cécile, Benameur Nordine, Tafflet Muriel, Beal Guillaume, Hagege Albert, Le Heuzey Jean-Yves, Desnos Michel, Spaulding Christian, Carré Francois, Dumas Florence, Celermajer David S, Cariou Alain, Jouven Xavier
Paris Cardiovascular Research Center, European Georges Pompidou Hospital, Paris, France; Paris Descartes University, Paris, France; Cardiology Department, Georges Pompidou European Hospital, Paris, France.
Paris Cardiovascular Research Center, European Georges Pompidou Hospital, Paris, France; Paris Descartes University, Paris, France; Intensive Care Unit, Cochin Hospital, Paris, France.
Am Heart J. 2015 Aug;170(2):339-345.e1. doi: 10.1016/j.ahj.2015.03.022. Epub 2015 May 9.
We sought to evaluate frequency, characteristics, and outcomes of sudden cardiac arrest (SCA) during sports activities according to the location of occurrence (in sports facilities vs those occurring outside of sports facilities).
This is an observational 5-year prospective national French survey of subjects 10 to 75 years old presenting with SCA during sports (2005-2010), in 60 French administrative regions (covering a population of 35 million people). Of the 820 SCA during sports, 426 SCAs (52%) occurred in sports facilities. Overall, a substantially higher survival rate at hospital discharge was observed among SCA in sports facilities (22.8%, 95% CI 18.8-26.8) compared to those occurring outside (8.0%, 95% CI 5.3-10.7) (P < .0001). Patients with SCA in sports facilities were younger (42.1 vs 51.3 years, P < .0001) and less frequently had known cardiovascular diseases (P < .0001). The events were more often witnessed (99.8% vs 84.9%, 0.0001), and bystander cardiopulmonary resuscitation was more frequently initiated (35.4% vs 25.9%, P = .003). Delays of intervention were significantly shorter when SCA occurred in sports facilities (9.3 vs 13.6, P=0.03), and the proportion of initially shockable rhythm was higher (58.8% vs 33.1%, P < .0001). Better survival in sports facilities was mainly explained by concomitant circumstances of occurrence (adjusted odds ratio 1.48, 95% CI 0.88-2.49, P = .134).
Sports-related SCA is not a homogeneous entity. The 3-fold higher survival rate reported among sports-related SCA is mainly due to cases that occur in sports facilities, whereas SCA during sports occurring outside of sports facilities has the usual very low rate of survival.
我们试图根据发生地点（体育设施内与体育设施外）评估体育活动期间心脏骤停（SCA）的频率、特征及结局。
这是一项为期5年的法国全国性前瞻性观察性研究，针对2005年至2010年间在法国60个行政区（覆盖3500万人口）出现体育活动期间心脏骤停的10至75岁受试者。在820例体育活动期间的心脏骤停中，426例（52%）发生在体育设施内。总体而言，与体育设施外发生的心脏骤停相比，体育设施内心脏骤停患者出院时的生存率显著更高（22.8%，95%可信区间18.8 - 26.8），而体育设施外为8.0%（95%可信区间5.3 - 10.7）（P < 0.0001）。体育设施内发生心脏骤停的患者更年轻（42.1岁对51.3岁，P < 0.0001），已知心血管疾病的发生率更低（P < 0.0001）。这些事件更常被目击（99.8%对84.9%，P = 0.0001），旁观者进行心肺复苏的频率更高（35.4%对25.9%，P = 0.003）。当心脏骤停发生在体育设施内时，干预延迟显著更短（9.3对13.6，P = 0.03），且初始可电击心律的比例更高（58.8%对33.1%，P < 0.0001）。体育设施内更好的生存率主要由伴随的发生情况所解释（校正比值比1.48，95%可信区间0.88 - 2.49，P = 0.134）。
与体育相关的心脏骤停并非一个同质的实体。报道的与体育相关心脏骤停中3倍更高的生存率主要归因于发生在体育设施内的病例，而体育设施外发生的体育活动期间心脏骤停的生存率通常很低。
