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31 August 2012

Cardiac arrest more common in young than thought

Cardiac arrest is relatively rare in young people, but it may be more common than experts have thought, according to a new study.

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Cardiac arrest is relatively rare in young people, but it may be more common than experts have thought, according to a new study.

Using 30 years of data from King County in Washington, researchers found that the rate of cardiac arrest among children and young adults was about 2.3 per 100 000 each year.

That's not a big risk. But the figure is substantially higher than the "widely accepted" estimate for young athletes (not just young people in general), said senior researcher Dr Jonathan Drezner.

According to that estimate, one in 200 000 young athletes (up to age 35) suffers cardiac arrest each year.

The good news from the current study is that young people's survival after cardiac arrest got much better over the 30-year period. It rose from 13% in the 1980s, to 40% between 2000 and 2009.

"It's very gratifying to see that our efforts are paying off," said Dr Dianne L Atkins, a paediatric cardiologist at the University of Iowa in Iowa City who wrote an editorial published with the study in the journal Circulation.

Research over the years has allowed experts to figure out the best way to perform cardiopulmonary resuscitation (CPR), and public campaigns have been done to encourage more people to learn CPR.

The true rate of cardiac arrest among kids and young adults has long been debated.

Dr Drezner said he thinks his team's findings come closer to the "real" figure than most past studies, because of its methodology.

The findings come from a cardiac arrest database kept by King County in Washington State. Emergency medical services report all cases of cardiac arrest to the registry.

Dr Drezner's team also used other records, like autopsy reports and hospital records, to try to figure out the cause of each cardiac arrest.

A clearer picture

Between 1980 and 2009, there were 361 cases of cardiac arrest logged for children and adults age 35 and younger - including 26 toddlers under age three, most of whom had congenital abnormalities.

That amounted to a rate of 2.28 cases for every 100 000 young people each year.

Dr Atkins agreed that this study gives a clearer picture of the true incidence of cardiac arrest in young people. "It's the best data we have."

And, she said, researchers should know how common the problem is before widespread screening programs, if any, can be put in place.

The idea of screening kids for heart problems that could cause cardiac arrest is controversial. Some countries, including Italy and Israel, have mandatory electrocardiogram (EKG) screening for young athletes. The U.S. does not.

Dr Atkins noted that while cardiac arrest can strike children, the risk should be kept in context. "It is still a very uncommon event," she said. "I don't think the message is that parents should be so frightened that they don't let their kids go out for competitive sports."

(Reuters Health, August 2012)

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