Study Reveals Racial Disparities in Survival Rates of Athletes After Cardiac Arrest

Research presented at the American College of Cardiology's Annual Scientific Session has unveiled significant racial disparities in the survival rates of athletes who experience sudden cardiac arrest. This critical study, which has been published in the Journal of the American College of Cardiology, highlights the varying outcomes based on race, location of the incident, and the activity being undertaken at the time of the collapse.

Each year, over 420,000 individuals in the United States suffer from out-of-hospital sudden cardiac arrest, a condition distinct from a heart attack. It is characterized by the abrupt cessation of heart function, often linked to undiagnosed heart conditions. Without immediate medical response, the condition can lead to death within minutes, underscoring the importance of prompt action, such as calling emergency services, performing cardiopulmonary resuscitation (CPR), and utilizing automated external defibrillators (AEDs).

The study found that while survival rates for athletes experiencing sudden cardiac arrest have improved over the past decade, significant differences remain among racial groups. Specifically, the research revealed that 57% of Black athletes and 54% of athletes from other non-white backgrounds did not survive cardiac arrest incidents during physical exertion between 2014 and 2023. In stark contrast, only 32% of white athletes in similar situations succumbed to the event.

Bradley J. Petek, a sports cardiologist at Oregon Health & Science University and the lead author of the study, expressed cautious optimism regarding the progress made in survival rates, attributing it to enhanced emergency preparedness initiatives. These include increased availability of AEDs and better training in CPR. However, the disparities observed among Black and other non-white athletes raise critical questions that require further investigation.

The analysis encompassed 641 cases of sudden cardiac arrest occurring among young athletes in the United States from 2014 to 2023. Data was sourced from the National Center for Catastrophic Sports Injury Research, which compiled information from news reports and various national databases. The average age of the athletes affected was 17, with cases spanning ages 11 to 29. Notably, the majority of incidents occurred in male athletes, with high school participants accounting for over 60% of the cases.

Overall, the study reported a survival rate of 49% among the 641 athletes. Approximately three-quarters of the cardiac arrests occurred during physical exertion, while the rest happened either at rest or after exertion. Survival rates varied significantly, with 68% of white athletes surviving cardiac arrests during physical activity, compared to only 43% of Black athletes and 46% of athletes from other racial backgrounds.

While survival rates showed a general upward trend during the study period--rising from 48% in the 2014-2015 academic year to 72% in 2022-2023--the researchers noted that data on CPR and AED usage during these incidents was not available. However, it was indicated that quicker responses, particularly during exertion, positively influenced survival outcomes. For instance, survival rates soared to 70% when cardiac arrests occurred during games or competitions, where access to AEDs was more common and bystanders were present, compared to a 53% survival rate during training sessions.

The research also indicated that survival rates varied by sport, with football and swimming exhibiting the lowest survival figures at 47% and 46%, respectively. The authors suggest that these lower rates may be partly due to the time required for emergency responders to reach athletes in protective gear or in the water.

The collapse and recovery of NFL player Damar Hamlin in 2023 spotlighted the issue of sudden cardiac arrest in young athletes, prompting the NFL to collaborate with organizations like the American College of Cardiology. This partnership aims to promote policies that enhance access to AEDs and CPR training in sports settings. Petek emphasized the importance of sustaining this momentum to improve emergency preparedness for all athletes, regardless of their location or the resources available.

Despite the critical insights provided by this study, the authors caution that the absence of a mandatory reporting system for cardiac arrests in young athletes means the data may not fully reflect all incidents that occurred during the study period. Future research is essential to explore the various factors contributing to racial disparities in survival rates and to identify strategies that could enhance outcomes for all athletes.