Article Text
Abstract
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 high school indicators of socioeconomic status (SES) and survival in student-athletes with exercise-related SCA.
Methods High school student-athletes in the USA with exercise-related SCA on school campuses were prospectively identified from 1 July 2014 to 30 June 2018 by the National Center for Catastrophic Sports Injury Research. High school indicators of SES included the following: median household and family income, proportion of students on free/reduced lunch and percent minority students. Resuscitation details included witnessed arrest, presence of an athletic trainer, bystander cardiopulmonary resuscitation and use of an on-site automated external defibrillator (AED). The primary outcome was survival to hospital discharge. Differences in survival were analysed using risk ratios (RR) and univariate general log-binomial regression models.
Results Of 111 cases identified (mean age 15.8 years, 88% male, 49% white non-Hispanic), 75 (68%) survived. Minority student-athletes had a lower survival rate compared with white non-Hispanic student-athletes (51.1% vs 75.9%; RR 0.67, 95% CI 0.49 to 0.92). A non-significant monotonic increase in survival was observed with increasing median household or family income and with decreasing percent minority students or proportion on free/reduced lunch. The survival rate was 83% if an athletic trainer was on-site at the time of SCA and 85% if an on-site AED was used.
Conclusions Minority student-athletes with exercise-related SCA on high school campuses have lower survival rates than white non-Hispanic athletes, but this difference is not fully explained by SES markers of the school.
- resuscitation
- sports
- cardiovascular diseases
- defibrillators
Data availability statement
All data relevant to the study are included in the article or uploaded as supplementary information.
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Data availability statement
All data relevant to the study are included in the article or uploaded as supplementary information.
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Footnotes
Twitter @rob_huggins_6, @DreznerJon
Contributors JS, KLK and JAD were responsible for the conception and design of the study, data acquisition and analysis, and drafting and revision of the manuscript. DFP and RAH were involved with data acquisition and analysis and provided critical revisions to the manuscript. All authors approve the final version and are accountable for all aspects of the work. JAD is the guarantor and responsible for the overall content.
Funding Supported by the National Center for Catastrophic Sports Injury Research (University of North Carolina at Chapel Hill), funded in part by the National Collegiate Athletic Association, the National Federation of State High School Associations, the American Football Coaches Association, the National Athletic Trainers’ Association, the National Operating Committee on Standards for Athletic Equipment and the American Medical Society for Sports Medicine. JS also received support from the University of Rochester School of Medicine and Dentistry, Research Training Program for his work on this study.
Competing interests JAD is editor-in-chief of BJSM.
Provenance and peer review Not commissioned; externally peer reviewed.
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