Socioeconomic Factors and Outcomes of Sudden Exercise-Related Cardiac Arrest in High School Student-Athletes in the United States
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Br J Sports Med. October 29, 2021: bjsports-2021-104486. doi: 10.1136 / bjsports-2021-104486. Online ahead of print.
OBJECTIVE: Minority student-athletes have a lower survival rate from sudden cardiac arrest (SCA) than non-minority student-athletes. This study examined the relationship between indicators of high school socioeconomic status (SES) and survival in student-athletes with exercise-related ACS.
METHODS: High school athlete in the United States with exercise-related ACS on school campuses were prospectively identified from July 1, 2014 to June 30, 2018 by the National Center for Catastrophic Sports Injury Research. The indicators for the SES at secondary level included the following: median household and family income, proportion of pupils receiving free / reduced lunch and percentage of pupils belonging to a minority. The details of the resuscitation included the witness arrest, the presence of a sports trainer, the cardiopulmonary resuscitation of a spectator and the use of an automated external defibrillator (AED) on site. The primary endpoint was survival until discharge from hospital. Differences in survival were analyzed using relative risks (RR) and general univariate log-binomial regression models.
RESULTS: Of 111 identified cases (mean age 15.8 years, 88% male, 49% non-Hispanic white), 75 (68%) survived. Minority student-athletes had a lower survival rate than white non-Hispanic student-athletes (51.1% vs. 75.9%; RR 0.67, 95% CI 0.49 to 0.92 ). A monotonically insignificant increase in survival was observed with increasing median household or family income and with decreasing percentage of minority students or proportion of free / reduced meals. The survival rate was 83% if an athletic trainer was on site at the time of the ACS and 85% if an on-site AED was used.
CONCLUSIONS: Minority student-athletes with exercise-related ACS on high school campuses have lower survival rates than non-Hispanic white athletes, but this difference is not fully explained by the SES markers of school.
IDPM: 34716143 | DOI: 10.1136 / bjsports-2021-104486