Bystander intervention may improve survival after exercise-related sudden cardiac arrest

1. On average, 71% of exercise-related sudden cardiac arrest (SCA) received bystander cardiopulmonary resuscitation (CPR) and 31% had an automated external defibrillator (AED) applied by a bystander.

2. The median survival rate to hospital discharge among exercise related SCA was 32%

Evidence Rating Level: 1 (Excellent)

Sudden cardiac arrest (SCA) is an issue affecting competitive and non-competitive athletes during exercise. Bystanders play an important role in responding to cardiac arrest events however the survival benefits have not been comprehensively examined. As a result, this systematic review seeks to evaluate rate of provision of cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) by bystanders as well as the rates of survival after exercise related SCA.

From 3711 identified records, 29 studies from inception to December 2020 were included in this systematic review. Studies were included if they reported bystander use of CPR and/or AED along with survival outcomes after exercise-relate SCA. Median proportions of bystander CPR and AED use were calculated as well as median rate of survival to hospital discharge. Risk of bias was assessed through the Newcastle-Ottawa Scale and most studies achieved a high score.

Results demonstrated that on average, 71% of exercise related SCA received bystander CPR and 31% had an AED applied by a bystander. In addition, the median survival rate to hospital discharge among exercise related SCA was 32%. It was found that both bystander CPR an AED use were significantly associated with survival after exercise-related SCA. However, this study was limited by the lack of examination of the time from collapse to initiation of CPR or AED which could influence survival outcomes. Nonetheless, this study provides early evidence that suggests the utility of CPR and AED use to improve survival after exercise related SCA.

Click to read the study in British Journal of Sports Medicine

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