(P146) SUDDEN CARDIAC ARREST SPORT IN THE YOUNG: INCIDENCE AND CHARACTERISTICS

Background: Sports-related sudden cardiac arrest (SCA) in the young (age ≤ 35) is rare but tragic. The incidence globally ranges from 0.3 to 1.3 per 100,000 person-years, but is unknown in Canada. The objective of this study is to describe the incidence and pattern of sports-related SCA in the young, in 5 Canadian Provinces: Ontario, Quebec, Nova Scotia, Saskatchewan, and British Columbia.

METHODS AND RESULTS: C-SCAN is a Canadian network measuring the scope of SCA. We conducted a retrospective cohort study using Emergency Medical Services (EMS) records from consecutive SCAs in individuals ≤ 35 years in age that had no obvious cause, were treated, and occurred during or ≤1 hour after sports activity. The catchment area included 2.9 million people between 12 and 35 years of age, with 9.4 million person-years of observation. The intensity level for each sport was assigned an estimated metabolic equivalent (MET). We defined moderate as a MET score of 3-5.9 and vigorous as ≥6.

Between January 1, 2016 - December 31, 2020, 38 sports-related SCAs occurred in individuals 12-35 years old (Table 1). Nine arrests occurred in individuals aged 12-17 years, 7 in people 18-24 years old, and 22 in people 25-35 years old. Most were male (81.6%; 31/38), with a median age of 26 years [IQR 20, 31]. The incidence was 0.4 per 100,000 person-years (95% CI, 0.3-0.5), with males having a higher incidence than females: 0.6 (95% CI: 0.4-0.9) vs. 0.2 (95% CI: 0-0.3) per 100,000 person-years, respectively. The incidence in individuals aged 12-17 years was 0.4 per 100,000 person-years (95% CI 0.1-0.7), in individuals 18-24 was 0.2 per 100,000 person-years (95% CI 0.1-0.4), and in individuals 25-35 was 0.5 per 100,000 person-years. (95% CI 0.3-0.7). Intensity was vigorous (50.0%; 19/38), moderate (13.2%; 5/38) moderate-vigorous (10.5%; 4/38), or unknown (26.3%; 10/38). Over half took place in recreational facilities (55.3%; 21/38), with high rates of bystander witnessed (84.2%; 32/38) and bystander CPR (76.3%; 29/38). AED shocks were delivered to 36.1% (13/36). Median EMS response time was 6 [IQR 4, 9] minutes, with initial shockable rhythm reported in 65.6% (21/32). Almost two thirds with known final vital status (64.9%; 24/37) survived to hospital discharge. Over 25% (10/38) reported symptoms ≤1 hour of sports activity, with chest pain (3/38; 7.9%), and feeling unwell (3/38; 7.9%) being most common.

Conclusion: The incidence of sports-related SCA is low in young people. Future work should seek to understand the etiology of such arrests.