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• W2412956604 abstract "The usefulness of pre-participation screening programs in preventing sudden cardiac death (SCD) during sport is highly controversial; these screening programs are mandatory in parts of Europe but not Canada. Assessing the potential effectiveness of a pre-participation screening program requires an accurate and comprehensive accounting of the number of cardiac arrests during sport in a defined geographic area and an accurate estimate of the number of individuals at risk. A population-based registry of all consecutive out-of-hospital cardiac arrests (OHCAs) attended by Emergency Medical Services (EMS) in the Greater Toronto Area (the Toronto Regional RescuNET Epistry-cardiac arrest database, total population of all ages 6.6 million) was used to identify cases aged 2-45 from 2009-2012. Cases were adjudicated as sudden cardiac arrest of presumed cardiac cause by 3 reviewers independently using data from ambulance call reports, police reports, coroner investigative statements, autopsy, toxicology, in-hospital data and direct patient interviews. All OHCAs during recreational (non-sanctioned sport/exercise) and competitive sport (any organized/sanctioned sporting event) were subsequently identified. The etiologies of OHCAs were determined by using autopsy reports (non-survivors), and medical records and/or patient interviews (survivors). The estimated number of competitive athletes at risk from ages 12-45 was calculated by using the total number of competitive athletes registered in Ontario in 2012 (Ontario Ministry of Tourism, Culture and Sport) prorated to the age-matched population in our geographical area using 2011 Canadian Census data. Out of 13.2 million patient years of observation, there were 662 adjudicated cardiac arrests of presumed cardiac cause, of which 11 cardiac arrests occurred during competitive sports and 40 during recreational sport. Of the competitive sport cohort, 36% survived, 73% had an initial shockable rhythm (VF/VT), 91% were male and the average age was 31 ± 10.9 years. The competitive sports included soccer, hockey, running, basketball, rugby and jujitsu. Potentially identifiable (with screening) causes included 2 arrhythmic and 1 hypertrophic cardiomyopathy (HCM) (see table). The incidence of competitive sport related cardiac arrest in the total athlete population is 0.92/100,000 per year (or 1/109,067). The incidence of competitive sport related cardiac arrest in the total population is 0.083/100,000 per year (or 1/1,205,582). Pre-participation screening for competitive athletes, even if 100% sensitive, could have potentially identified 3 persons at risk for non-coronary related cardiac arrest, out of about 300,000 persons at risk. Screening all competitive young athletes is likely to be extremely inefficient at preventing organized sport related sudden deaths." @default.
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• W2412956604 date "2015-10-01" @default.
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• W2412956604 title "HOW USEFUL IS A PRE-PARTICIPATION SCREENING PROGRAM TO PREVENT CARDIAC ARREST DURING SPORT? INSIGHTS FROM A REGISTRY OF ALL SPORTS-RELATED CARDIAC ARRESTS IN A LARGE URBAN POPULATION" @default.
• W2412956604 doi "https://doi.org/10.1016/j.cjca.2015.07.260" @default.
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