University of Washington, Seattle.
University of South Carolina Greenville, Greenville, SC.
Mayo Clin Proc. 2016 Nov;91(11):1493-1502. doi: 10.1016/j.mayocp.2016.07.021. Epub 2016 Sep 28.
To determine the incidence and etiology of sudden cardiac arrest and death (SCA/D) in US high school athletes.
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.
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%]).
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.
确定美国高中生运动员心源性猝死和死亡（SCA/D）的发生率和病因。
对 7 个州在 6 个学年（2007 年 9 月 1 日至 2013 年 8 月 30 日）期间的 14 至 18 岁青少年心源性猝死数据库进行前瞻性媒体检索。调查事件详情，以确定是否参加高中运动队、性别、运动项目以及是否在学校组织的活动或运动中发生。使用全国体育参与人数，并应用转换系数来计算多运动项目运动员的人数。审查尸检报告，并由专家组裁定死亡原因。
共检查了 16390409 个运动员赛季，代表 6974640 个运动员年（AY），涵盖了美国高中生运动员总数的 36%。共发现 104 例 SCA/D（35 例 SCA 伴存活和 69 例心源性猝死[SCD]）。SCD 的发生率为 1:101082 AY，SCA/D 的发生率为 1:67064 AY。88%（92 例）的事件发生在男性运动员中。男性运动员 SCA/D 的发生率为 1:44832 AY，女性运动员为 1:237510 AY（发病率比，5.3；95%CI，2.9-10.6；P<.001）。男子篮球是风险最高的运动，SCA/D 的发生率为 1:37087 AY，其次是男子足球，发生率为 1:86494 AY。男子篮球和足球运动员占死亡人数的 57%（39 例）。80%的 SCD（69 例中的 55 例）是运动性的，55%（69 例中的 38 例）发生在学校组织的球队比赛中。73%（50 例）的病例获得了尸检报告。尸检最常见的发现是特发性左心室肥厚或可能的心肌病（50 例中的 13 例[26%]）、尸检阴性的不明原因突发死亡（50 例中的 9 例[18%]）、肥厚型心肌病（50 例中的 7 例[14%]）和心肌炎（50 例中的 7 例[14%]）。
男性高中生运动员 SCA/D 的发生率为 1:44832 AY，其中近一半归因于可能或确诊的心肌病疾病。由于依赖媒体报道，可能有许多病例未被发现，这些数字仅代表最低估计值。
