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February 16, 2009Circulation2,082 citationsOpen Access

Sudden Deaths in Young Competitive Athletes

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BMBarry J. MaronJDJoseph J. DoererTHTammy S. Haas

Key Result

From 1980 to 2006, 1866 sudden deaths were reported in young athletes, predominantly due to cardiovascular disease, averaging 66 deaths annually in the last six years.

Key Points

  • This research aims to estimate the occurrence of sudden deaths in young competitive athletes in the US and identify their causes.
  • Assembled a national registry over 27 years from 1980 to 2006.
  • Identified 1866 athletes who experienced sudden death or cardiac arrest.
  • Categorized deaths by causes, focusing on cardiovascular issues and other contributing factors.
  • Analyzed trends in reporting over two distinct periods (1980-1993 and 1994-2006).
  • Identified a total of 1866 sudden deaths among young athletes aged 19±6 years.
  • Most deaths (56%) resulted from cardiovascular disease, with hypertrophic cardiomyopathy being the most common cause (36%).
  • Sudden deaths increased by 6% annually and were more frequently reported from 1994 to 2006.
  • Only 11% of the deaths occurred in females, although this percentage rose over time.

Structured PICO

P
Population
Young competitive athletes in the US (aged ≤39 years) who died suddenly or survived cardiac arrest
O
Outcome
Absolute number and causes of sudden deaths in US competitive athleteshard clinical

The absolute number of cardiovascular sudden deaths in young US athletes is higher than previously estimated but remains relatively low (<100 per year), highlighting the need for mandatory reporting and informing the debate on preparticipation screening.

Limitations

  • Ascertainment bias with likely underestimation of deaths due to reliance on public domain and media reports
  • Inability to reliably assign a precise cause of death in 513 athletes due to lack of autopsy, privacy restrictions, or ambiguous reports

Abstract

Background— Sudden deaths in young competitive athletes are highly visible events with substantial impact on the physician and lay communities. However, the magnitude of this public health issue has become a source of controversy. Methods and Results— To estimate the absolute number of sudden deaths in US competitive athletes, we have assembled a large registry over a 27-year period using systematic identification and tracking strategies. A total of 1866 athletes who died suddenly (or survived cardiac arrest), 19±6 years of age, were identified throughout the United States from 1980 to 2006 in 38 diverse sports. Reports were less common during 1980 to 1993 (576 31%) than during 1994 to 2006 (1290 69%, P <0.001) and increased at a rate of 6% per year. Sudden deaths were predominantly due to cardiovascular disease (1049 56%), but causes also included blunt trauma that caused structural damage (416 22%), commotio cordis (65 3%), and heat stroke (46 2%). Among the 1049 cardiovascular deaths, the highest number of events in a single year was 76 (2005 and 2006), with an average of 66 deaths per year (range 50 to 76) over the last 6 years; 29% occurred in blacks, 54% in high school students, and 82% with physical exertion during competition/training, whereas only 11% occurred in females (although this increased with time; P =0.023). The most common cardiovascular causes were hypertrophic cardiomyopathy (36%) and congenital coronary artery anomalies (17%). Conclusions— In this national registry, the absolute number of cardiovascular sudden deaths in young US athletes was somewhat higher than previous estimates but relatively low nevertheless, with a rate of <100 per year. These data are relevant to the current debate surrounding preparticipation screening programs with ECGs and also suggest the need for systematic and mandatory reporting of athlete sudden deaths to a national registry.

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Cite This Study

Maron et al. (2009) studied this question. From 1980 to 2006, 1866 sudden deaths were reported in young athletes, predominantly due to cardiovascular disease, averaging 66 deaths annually in the last six years.

synapsesocial.com/papers/69656df3873b4ad8b4456418https://doi.org/10.1161/circulationaha.108.804617
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