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Cardiac arrest survival at school basketball events more likely vs. games at select clubs



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Survival to hospital discharge after sudden cardiac arrest was more likely during school-sponsored basketball events compared with select club-sponsored events, researchers reported.

Additionally, Black race and cardiac arrest during club-sponsored basketball events were both associated with fewer instances of confirmed CPR and use of an on-site automated external defibrillator, according to data published in Circulation: Cardiovascular Quality and Outcomes.


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“Male basketball players have the highest risk for sudden cardiac arrest compared with other athlete groups. This study examined survival in adolescent male basketball players with sudden cardiac arrest,” Jonathan A. Drezner, MD, professor in the department of family medicine at the University of Washington, director of the UW Medicine Center for Sports Cardiology and team physician for the Seattle Seahawks, OL Reign and UW Huskies, told Healio. “Athletes with sudden cardiac arrest at a school-sponsored event — practice or game — were about twice as likely to survive and receive CPR/AED compared with athletes with sudden cardiac arrest at a club-sponsored — non-school — event. Survival in Black athletes was two times lower than in white athletes.”

Researchers used data from the National Center for Catastrophic Sport Injury Research collected from July 2014 to June 2020, during which time 60 cases of sudden cardiac arrest occurred among male adolescent basketball players (mean age, 15 years; 45% Black).

The primary outcome was survival to hospital discharge after sudden cardiac arrest at school-sponsored compared with select club-sponsored basketball events; however, researchers also assessed the impact of race on outcomes and cardiac arrest responsiveness.

Sudden cardiac arrest response and outcomes

Overall, 42% of cases occurred during basketball games, whereas 58% occurred during practice (57% during a high school event; 13% during a middle school event; 30% during a select club event).

Most select-club events were sponsored by the Amateur Athletic Union.

Survival to discharge was lower among adolescent basketball players who experienced cardiac arrest during a select club event compared with school events (39% vs. 67%; P = .05).

Survival was also lower among Black basketball players (37%) and players of other race (50%) compared with white basketball players (74%; P = .02).

Black basketball players represented 61% of sudden cardiac arrests at select club events and 38% of sudden cardiac arrests at school events.

CPR was performed in 90% of cardiac arrests occurring at school basketball events compared with 56% of cases at select club events; however, performance of bystander CPR was unknown in 44% of cardiac arrests at select club events.

The use of an on-site AED was confirmed in 64% of cardiac arrests at school events compared with 22% of cases at select club events, according to the study.

‘An urgent need to improve emergency planning’

Jonathan A. Drezner

“There is an urgent need to improve emergency planning for sudden cardiac arrest in club/non-school sporting events such as youth basketball leagues and teams,” Drezner told Healio. “Youth coaches, such as in AAU basketball, should be trained in recognition of sudden cardiac arrest, CPR and AED use. Schools should have a routine hand-off of their emergency action plan for clubs that are renting their gymnasiums. For clubs with their own facilities, on-site access to an AED should be standard.”

For more information:

Jonathan A. Drezner, MD, can be reached at jdrezner@uw.edu.

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