非运动相关事件中心脏震荡：系统评价。
Commotio Cordis in Non-Sport-Related Events: A Systematic Review.
机构信息
University of Melbourne Faculty of Medicine, Dentistry and Health Sciences, Melbourne, Victoria, Australia; Austin Health, Melbourne, Victoria, Australia.
University of Melbourne Faculty of Medicine, Dentistry and Health Sciences, Melbourne, Victoria, Australia; Austin Health, Melbourne, Victoria, Australia. Electronic address: https://twitter.com/drThalysSR.
出版信息
JACC Clin Electrophysiol. 2023 Aug;9(8 Pt 1):1321-1329. doi: 10.1016/j.jacep.2023.01.010. Epub 2023 Mar 22.
BACKGROUND
Commotio cordis is an increasingly recognized cause of sudden cardiac death. Although commonly linked with athletes, many events occur in non-sport-related settings.
OBJECTIVES
The goal of this study was to characterize and compare non-sport-related vs sport-related commotio cordis.
METHODS
PubMed and Embase were searched for all cases of commotio cordis from inception to January 5, 2022.
RESULTS
Of 334 commotio cordis cases identified, 121 (36%) occurred in non-sport-related contexts, which included assault (76%), motor vehicle accidents (7%), and daily activities (16%). Projectiles were implicated significantly less in non-sport-related events (5% vs 94%, respectively; P < 0.001). Nonprojectile etiologies in non-sport-related events mostly consisted of impacts with body parts (79%). Both categories affected similar younger aged demographic (P = 0.10). The proportion of female victims was significantly higher in non-sport-related events (13% vs 2%, respectively; P = 0.025). Mortality was significantly higher in non-sport-related events (88% vs 66%, respectively; P < 0.001). In non-sport-related events, rates of cardiopulmonary resuscitation (27% vs 97%, respectively; P < 0.001) and defibrillation (17% vs 81%, respectively; P < 0.001) were both lower and resuscitation was more commonly delayed beyond 3 min (80% vs 5%, respectively; P < 0.001).
CONCLUSIONS
Commotio cordis occurs across a spectrum of non-sport-related settings including assault, motor vehicle accidents, and daily activities. Both categories affected a younger and male-predominant demographic. Mortality is higher in non-sport-related commotio cordis, likely owing to lower rates of cardiopulmonary resuscitation, defibrillation, automated external defibrillator availability, and extended time to resuscitation. Increased awareness of non-sport-related commotio cordis is essential to develop a means of prevention and mortality reduction, with earlier recognition and prompt resuscitation measures.
背景
心震综合征是越来越被认可的导致心源性猝死的原因。尽管通常与运动员相关，但许多事件发生在非运动相关的环境中。
目的
本研究的目的是描述和比较非运动相关与运动相关的心震综合征。
方法
从建库至 2022 年 1 月 5 日，在 PubMed 和 Embase 中检索所有心震综合征病例。
结果
在确定的 334 例心震综合征病例中，有 121 例（36%）发生在非运动相关环境中，包括袭击（76%）、机动车事故（7%）和日常活动（16%）。在非运动相关事件中，明显较少涉及投射物（分别为 5%和 94%；P<0.001）。非运动相关事件中的非投射病因主要由身体部位的撞击组成（79%）。这两个类别影响相似的年轻人群（P=0.10）。女性受害者在非运动相关事件中的比例明显更高（分别为 13%和 2%；P=0.025）。非运动相关事件中的死亡率明显更高（分别为 88%和 66%；P<0.001）。在非运动相关事件中，心肺复苏（分别为 27%和 97%；P<0.001）和除颤（分别为 17%和 81%；P<0.001）的比例均较低，并且复苏更常延迟超过 3 分钟（分别为 80%和 5%；P<0.001）。
结论
心震综合征发生在包括袭击、机动车事故和日常活动在内的一系列非运动相关环境中。这两个类别都影响了更年轻和男性为主的人群。非运动相关的心震综合征死亡率较高，可能是由于心肺复苏、除颤、自动体外除颤器的可用性和复苏时间延长导致的。提高对非运动相关的心震综合征的认识对于制定预防和降低死亡率的方法至关重要，需要更早的识别和及时的复苏措施。
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