Cardiology Department, Ospdale Guglielmo da Saliceto, Piacenza, Italy.
Cardiology and Arrhythmology Clinic, Marche Polytechnic University, University Hospital 'Ospedali Riuniti', Ancona, Italy.
Heart. 2018 Aug;104(16):1344-1349. doi: 10.1136/heartjnl-2017-312441. Epub 2018 Feb 20.
Sudden cardiac arrest (SCA) is a rare but tragic event during amateur sports activities. Our aim is to analyse whether availability of automated external defibrillators (AEDs) in amateur sports centres could impact on SCA survival.
This is an observational study. During an 18-year period, data regarding exercise-related SCA in sports centres were prospectively collected. Survival rates and time to response were compared between centres with an AED already available and centres where an AED was not already present.
Out of 252 sports facilities, 207 (82%) acquired an AED during follow-up while 45 (18%) did not. From 1999 to 2014, there were 26 SCAs (24 (92%) men, 54±17 years old) with 15 (58%) of them in centres with on-site AED. Neurologically intact survival rates were 93% in centres with on-site AED and 9% in centres without (P<0.001). Presence of on-site AED, presence of shockable rhythm, first assistance by a lay bystander and time to defibrillation were all related to neurological intact survival, but the presence of on-site AED was the only independent predictor in the multivariate analysis. The use of on-site AED resulted in a lower time to first shock when compared with emergency medical system-delivered AED (3.3±1.4min vs 7.3±3.2 min; P=0.001).
The presence of on-site AEDs is associated with neurologically intact survival after an exercise-related SCA. Continuous efforts are recommended in order to introduce AEDs in sports and fitness centres, implement educational programmes and increase common awareness about SCA.
心脏骤停（SCA）是业余体育活动中罕见但悲惨的事件。我们的目的是分析业余体育中心是否配备自动体外除颤器（AED）是否会影响 SCA 的存活率。
这是一项观察性研究。在 18 年的时间里，前瞻性收集了运动中心与运动相关的 SCA 数据。比较了已经配备 AED 的中心和尚未配备 AED 的中心的存活率和反应时间。
在 252 个体育设施中，207 个（82%）在随访期间配备了 AED，而 45 个（18%）没有。从 1999 年到 2014 年，有 26 例 SCA（24 例（92%）男性，54±17 岁），其中 15 例（58%）在有现场 AED 的中心。有现场 AED 的中心的神经功能完整存活率为 93%，而没有现场 AED 的中心的存活率为 9%（P<0.001）。有现场 AED、有可除颤节律、由非专业旁观者进行的首次急救和除颤时间均与神经功能完整存活率相关，但在多变量分析中，有现场 AED 是唯一的独立预测因素。与紧急医疗系统提供的 AED 相比，使用现场 AED 可缩短首次电击时间（3.3±1.4min 比 7.3±3.2min；P=0.001）。
有现场 AED 可提高与运动相关的 SCA 后神经功能完整的存活率。建议持续努力，在体育和健身中心引入 AED、实施教育计划并提高对 SCA 的普遍认识。
