Incidence, cause, and comparative frequency of sudden cardiac death in national collegiate athletic association athletes a decade in review

Kimberly G. Harmon, Irfan M. Asif, Joseph Maleszewski, David S. Owens, Jordan M. Prutkin, Jack C. Salerno, Monica L. Zigman, Rachel Ellenbogen, Ashwin L. Rao, Michael John Ackerman, Jonathan A. Drezner

Research output: Contribution to journalArticle

151 Citations (Scopus)

Abstract

Background-The incidence and cause of sudden cardiac death (SCD) in athletes is debated with hypertrophic cardiomyopathy often reported as the most common cause. Methods and Results-A database of all National Collegiate Athletic Association deaths (2003-2013) was developed. Additional information and autopsy reports were obtained when possible. Cause of death was adjudicated by an expert panel. There were 4 242 519 athlete-years (AY) and 514 total student athlete deaths. Accidents were the most common cause of death (257, 50%, 1:16 508 AY) followed by medical causes (147, 29%, 1:28 861 AY). The most common medical cause of death was SCD (79, 15%, 1:53 703 AY). Males were at higher risk than females 1:37 790 AY versus 1:121 593 AY (incidence rate ratio, 3.2; 95% confidence interval, 1.9-5.5; P<0.00001), and black athletes were at higher risk than white athletes 1:21491 AY versus 1:68 354 AY (incidence rate ratio, 3.2; 95% confidence interval, 1.9-5.2; P<0.00001). The incidence of SCD in Division 1 male basketball athletes was 1:5200 AY. The most common findings at autopsy were autopsy-negative sudden unexplained death in 16 (25%), and definitive evidence for hypertrophic cardiomyopathy was seen in 5 (8%). Media reports identified more deaths in higher divisions (87%, 61%, and 44%), whereas the percentages from the internal database did not vary (87%, 83%, and 89%). Insurance claims identified only 11% of SCDs. Conclusions-The rate of SCD in National Collegiate Athletic Association athletes is high, with males, black athletes, and basketball players at substantially higher risk. The most common finding at autopsy is autopsy-negative sudden unexplained death. Media reports are more likely to capture high-profile deaths, and insurance claims are not a reliable method for case identification.

Original languageEnglish (US)
Pages (from-to)10-19
Number of pages10
JournalCirculation
Volume132
Issue number1
DOIs
StatePublished - 2015

Fingerprint

Sudden Cardiac Death
Athletes
Sports
Incidence
Autopsy
Basketball
Cause of Death
Hypertrophic Cardiomyopathy
Sudden Death
Insurance
Databases
Confidence Intervals
Accidents

Keywords

  • Athletes
  • Death
  • Epidemiology
  • Pathology
  • Sudden

ASJC Scopus subject areas

  • Physiology (medical)
  • Cardiology and Cardiovascular Medicine

Cite this

Incidence, cause, and comparative frequency of sudden cardiac death in national collegiate athletic association athletes a decade in review. / Harmon, Kimberly G.; Asif, Irfan M.; Maleszewski, Joseph; Owens, David S.; Prutkin, Jordan M.; Salerno, Jack C.; Zigman, Monica L.; Ellenbogen, Rachel; Rao, Ashwin L.; Ackerman, Michael John; Drezner, Jonathan A.

In: Circulation, Vol. 132, No. 1, 2015, p. 10-19.

Research output: Contribution to journalArticle

Harmon, Kimberly G. ; Asif, Irfan M. ; Maleszewski, Joseph ; Owens, David S. ; Prutkin, Jordan M. ; Salerno, Jack C. ; Zigman, Monica L. ; Ellenbogen, Rachel ; Rao, Ashwin L. ; Ackerman, Michael John ; Drezner, Jonathan A. / Incidence, cause, and comparative frequency of sudden cardiac death in national collegiate athletic association athletes a decade in review. In: Circulation. 2015 ; Vol. 132, No. 1. pp. 10-19.
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abstract = "Background-The incidence and cause of sudden cardiac death (SCD) in athletes is debated with hypertrophic cardiomyopathy often reported as the most common cause. Methods and Results-A database of all National Collegiate Athletic Association deaths (2003-2013) was developed. Additional information and autopsy reports were obtained when possible. Cause of death was adjudicated by an expert panel. There were 4 242 519 athlete-years (AY) and 514 total student athlete deaths. Accidents were the most common cause of death (257, 50{\%}, 1:16 508 AY) followed by medical causes (147, 29{\%}, 1:28 861 AY). The most common medical cause of death was SCD (79, 15{\%}, 1:53 703 AY). Males were at higher risk than females 1:37 790 AY versus 1:121 593 AY (incidence rate ratio, 3.2; 95{\%} confidence interval, 1.9-5.5; P<0.00001), and black athletes were at higher risk than white athletes 1:21491 AY versus 1:68 354 AY (incidence rate ratio, 3.2; 95{\%} confidence interval, 1.9-5.2; P<0.00001). The incidence of SCD in Division 1 male basketball athletes was 1:5200 AY. The most common findings at autopsy were autopsy-negative sudden unexplained death in 16 (25{\%}), and definitive evidence for hypertrophic cardiomyopathy was seen in 5 (8{\%}). Media reports identified more deaths in higher divisions (87{\%}, 61{\%}, and 44{\%}), whereas the percentages from the internal database did not vary (87{\%}, 83{\%}, and 89{\%}). Insurance claims identified only 11{\%} of SCDs. Conclusions-The rate of SCD in National Collegiate Athletic Association athletes is high, with males, black athletes, and basketball players at substantially higher risk. The most common finding at autopsy is autopsy-negative sudden unexplained death. Media reports are more likely to capture high-profile deaths, and insurance claims are not a reliable method for case identification.",
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AU - Owens, David S.

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