Until now, studies of SCD during sport have been largely focused on young competitiveathletes, despite such groups making only a minor contribution to sudden death during sport. In May 2005 Eloi Marijon and colleagues, from the European Georges Pompidou Hospital in Paris, began the first prospective observational study to analyse sudden deaths during sports activity in the general French population. Information was obtained from the emergency medical services (SAMU) and news media reports.
The study, which was progressively extended to 70 of France's 95 departments, documented 404 unselected sports-related SCDs. Results show that the mean age was 47(± 15 years), and that the vast majority of subjects (more than 95%) were male.
The incidence of SCDs occurred predominantly in the three most frequently practised sports - cycling (33 %), running (22%) and soccer (12%), with intense physical activity reported in 40% of cases, moderate activity in 54% of deaths and light activity in 7%.
Despite the fact that 72% of sports-related SCDs occur in public sports areas, only 40% of subjects in this study benefited from early resuscitation before the arrival of the emergency services. When a bystander did administer immediate CPR, however, survival on hospital admission was four-fold higher, increasing to ten-fold higher when defibrillators were used.
“Bystanders appear to be too inhibited and afraid to start CPR," says Marijon. "What this study clearly demonstrating is an urgent requirement for more extensive education in the general public. Increasing the availability of cardioverter defibrillators would only be worthwhile if the public are prepared to use them."
The study also highlights the role of familial screening following SCD, with less than 25% of the families of SCD victims having familial screening. “Familial screening may decrease the risk of dying suddenly for other members of the family,” said Marijon.