Bystander CPR and public AED use were associated with a 2- to 4-fold increase in survival (OR 2.5-4.2) following sudden cardiac arrest.
Systematic Review
Do prevention strategies and emergency response interventions (bystander CPR, AED use) improve survival from sudden cardiac arrest in athletes and the general population?
Bystander CPR and public AED use significantly increase survival from sudden cardiac arrest, highlighting the critical need for universal CPR training and equitable AED access.
Effect estimate: OR 2.5-4.2
Background: Sudden cardiac arrest (SCA) remains a leading cause of death in athletes and a major public health burden. Significant disparities in survival persist, indicating gaps in prevention, preparedness, and response systems. Objective: This systematic review synthesizes contemporary evidence (2017-2024) on risk factors, prevention efficacy, and emergency response outcomes for SCA in athletes (particularly footballers) versus the general adult population. Methods: Following PRISMA 2020 guidelines, we searched PubMed, Embase, Scopus, and Web of Science. Included studies reported on SCA incidence, risk stratification, prevention (e.g., screening), or pre-hospital response. Data were extracted systematically, and quality was assessed using Joanna Briggs Institute checklists. Results: Of 2,158 records, 18 studies were included. In athletes, primary risks were cardiomyopathies and coronary anomalies, with an incidence of 1:50,000–1:80,000 athlete-years. Pre-participation ECG screening showed variable sensitivity (65-85%) and high specificity (90-98%). In the general population, coronary artery disease was the predominant cause (>80%). Bystander CPR and public AED use were associated with a 2- to 4-fold increase in survival (OR=2.5–4.2), though significant access and response disparities existed. Conclusion: A stratified prevention approach is essential: protocol-driven screening for athletes and aggressive management of modifiable risk factors in the general population. Equitable AED access and universal bystander CPR training are critical to improving survival. Future research should evaluate cost-effective screening and AI-enhanced risk prediction.
Eling et al. (Wed,) conducted a systematic review in Sudden cardiac arrest. Bystander CPR and public AED use vs. No bystander CPR or AED use was evaluated on Survival (OR 2.5-4.2). Bystander CPR and public AED use were associated with a 2- to 4-fold increase in survival (OR 2.5-4.2) following sudden cardiac arrest.