title: Major regional disparities in outcomes after sudden cardiac arrest during sports.
abstract: OBJECTIVE
  Characteristics of sudden cardiac arrest (SCA) during sports offers a novel (and unexplored) setting to assess factors associated with disparities in outcomes across regions.
  
  
  RESULTS
  From a prospective 5-year community-based French registry concerning SCA during sports in 10-75 year-olds, we evaluated whether outcomes differed significantly between geographic regions. We then determined the extent to which variations in community-related early interventions were associated with regional variations in survival. Among 820 SCA cases studied, overall survival at hospital discharge was 15.7% (95% confidence interval, 13.2-18.2%), with considerable regional disparities (from 3.4 to 42.6%, P < 0.001). Major differences were noted regarding bystander initiation of cardiopulmonary resuscitation (15.3-80.9%, P < 0.001) and presence of initial shockable rhythm (28.6-79.1%, P < 0.001), with higher values of these being associated with better survival rates. The proportion of survivors with favourable neurological outcome at discharge was fairly uniform among survival groups (CPC-1/2, varying from 77.4 to 90.0%, P = 0.83). No difference was observed regarding subjects' characteristics and circumstances of SCA occurrence, including delays in resuscitation (collapse-to-call period). With a comparable in-hospital mortality (P = 0.44), survival at hospital discharge was highly correlated with that at hospital admission (regional variations from 7.4 to 75.0%, P < 0.001).
  
  
  CONCLUSIONS
  Major regional disparities exist in survival rates (up to 10-fold) after SCA during sports. SCA cases from regions with the highest levels of bystander resuscitation had the best survival rates to hospital admission and discharge.
authors.affiliation: Paris Cardiovascular Research Center (PARCC), INSERM Unit 970, Paris, France.
authors.forename: Eloi
authors.initials: E
authors.lastname: Marijon
authors.forename: Wulfran
authors.initials: W
authors.lastname: Bougouin
authors.forename: David S
authors.initials: DS
authors.lastname: Celermajer
authors.forename: Marie-Cécile
authors.initials: MC
authors.lastname: Perier
authors.forename: Nordine
authors.initials: N
authors.lastname: Benameur
authors.forename: Lionel
authors.initials: L
authors.lastname: Lamhaut
authors.forename: Nicole
authors.initials: N
authors.lastname: Karam
authors.forename: Florence
authors.initials: F
authors.lastname: Dumas
authors.forename: Muriel
authors.initials: M
authors.lastname: Tafflet
authors.forename: Christof
authors.initials: C
authors.lastname: Prugger
authors.forename: Hazrije
authors.initials: H
authors.lastname: Mustafic
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Rifler
authors.forename: Michel
authors.initials: M
authors.lastname: Desnos
authors.forename: Jean-Yves
authors.initials: JY
authors.lastname: Le Heuzey
authors.forename: Christian M
authors.initials: CM
authors.lastname: Spaulding
authors.forename: Paul
authors.initials: P
authors.lastname: Avillach
authors.forename: Alain
authors.initials: A
authors.lastname: Cariou
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Empana
authors.forename: Xavier
authors.initials: X
authors.lastname: Jouven
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016887:Cardiopulmonary Resuscitation / Q000401:mortality / Q000706:statistics & numerical data; D002648:Child; D047548:Defibrillators / Q000706:statistics & numerical data; D005260:Female; D005602:France / Q000453:epidemiology; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008020:Life Support Care / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D058687:Out-of-Hospital Cardiac Arrest / Q000401:mortality* / Q000628:therapy; D011446:Prospective Studies; D012042:Registries; D012111:Residence Characteristics / Q000706:statistics & numerical data; D013177:Sports / Q000706:statistics & numerical data*; D015996:Survival Rate; D055815:Young Adult
keywords: Basic life support; Bystander; Cardiopulmonary resuscitation; Defibrillation; Delay; Education