Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada
Department of Medicine, Queen's University, Kingston, Ontario, Canada.
Br J Sports Med. 2022 Apr;56(7):410-416. doi: 10.1136/bjsports-2021-104623. Epub 2021 Dec 1.
To evaluate the provision of bystander interventions and rates of survival after exercise-related sudden cardiac arrest (SCA).
Systematic review.
MEDLINE, EMBASE, PubMed, CINAHL, SPORTDiscus, Cochrane Library and grey literature sources were searched from inception to November/December 2020.
Observational studies assessing a population of exercise-related SCA (out-of-hospital cardiac arrests that occurred during exercise or within 1 hour of cessation of activity), where bystander cardiopulmonary resuscitation (CPR) and/or automated external defibrillator (AED) use were reported, and survival outcomes were ascertained.
Among all included studies, the median (IQR) proportions of bystander CPR and bystander AED use, as well as median (IQR) rate of survival to hospital discharge, were calculated.
A total of 29 studies were included in this review, with a median study duration of 78.7 months and a median sample size of 91. Most exercise-related SCA patients were male (median: 92%, IQR: 86%-96%), middle-aged (median: 51, IQR: 39-56 years), and presented with a shockable arrest rhythm (median: 78%, IQR: 62%-86%). Bystander CPR was initiated in a median of 71% (IQR: 59%-87%) of arrests, whereas bystander AED use occurred in a median of 31% (IQR: 19%-42%) of arrests. Among the 19 studies that reported survival to hospital discharge, the median rate of survival was 32% (IQR: 24%-49%). Studies which evaluated the relationship between bystander interventions and survival outcomes reported that both bystander CPR and AED use were associated with survival after exercise-related SCA.
Exercise-related SCA occurs predominantly in males and presents with a shockable ventricular arrhythmia in most cases, emphasising the importance of rapid access to defibrillation. Further efforts are needed to promote early recognition and a rapid bystander response to exercise-related SCA.
评估与运动相关的心脏骤停（SCA）后旁观者干预措施的提供情况和生存率。
系统评价。
从开始到 2020 年 11 月/12 月，检索了 MEDLINE、EMBASE、PubMed、CINAHL、SPORTDiscus、Cochrane 图书馆和灰色文献来源。
评估运动相关 SCA 人群（在运动中或活动停止后 1 小时内发生的院外心脏骤停）的观察性研究，其中报告了旁观者心肺复苏术（CPR）和/或自动体外除颤器（AED）的使用情况，并确定了生存结果。
在所有纳入的研究中，计算了旁观者 CPR 和旁观者 AED 使用的中位数（IQR）比例，以及中位数（IQR）的生存率到出院。
本综述共纳入 29 项研究，中位研究时间为 78.7 个月，中位样本量为 91 例。大多数运动相关 SCA 患者为男性（中位数：92%，IQR：86%-96%），中年（中位数：51 岁，IQR：39-56 岁），呈现可除颤性心律失常（中位数：78%，IQR：62%-86%）。旁观者 CPR 在中位数 71%（IQR：59%-87%）的发作中启动，而旁观者 AED 使用中位数为 31%（IQR：19%-42%）的发作。在 19 项报告生存率到出院的研究中，中位生存率为 32%（IQR：24%-49%）。评估旁观者干预措施与生存结果之间关系的研究报告称，旁观者 CPR 和 AED 使用均与运动相关 SCA 后的生存率相关。
运动相关 SCA 主要发生在男性中，大多数情况下表现为可除颤性室性心律失常，这强调了快速除颤的重要性。需要进一步努力促进对运动相关 SCA 的早期识别和快速旁观者反应。
