Increasing survival rate from commotio cordis

Barry J. Maron, Tammy S. Haas, Aneesha Ahluwalia, Ross F. Garberich, N. A. Mark Estes, Mark S. Link

Research output: Contribution to journalArticle

42 Citations (Scopus)

Abstract

Background Commotio cordis events due to precordial blows triggering ventricular fibrillation are a cause of sudden death (SD) during sports and also daily activities. Despite the absence of structural cardiac abnormalities, these events have been considered predominantly fatal with low survival rates. Objective To determine whether expected mortality rates for commotio cordis have changed over time, associated with greater public visibility. Methods US Commotio Cordis Registry was accessed to tabulate frequency of reported SD or resuscitated cardiac arrest over 4 decades. Results At their commotio cordis event, 216 study patients were 0.2–51 years old (mean age 15±9 years); 95% were males. Death occurred in 156 individuals (72%), while the other 60 (28%) survived. Proportion of survivors increased steadily with concomitant decrease in fatal events. For the initial years (1970–1993), 6 of 59 cases survived (10%), while during 1994–2012, 54 of 157 (34%) survived (P =.001). The most recent 6 years, survival from commotio cordis was 31 of 53 (58%), with survivor and nonsurvivor curves ultimately crossing. Higher survival rates were associated with more prompt resuscitation (40%<3 minutes vs 5%>3 minutes; P<.001) and participation in competitive sports (39% P<.001), but with lower rates in African Americans (1 of 24; 4%) than in whites (54 of 166; 33% P =.004). Independent predictors of mortality were black race (P =.045) and participation in noncompetitive sports (P =.002), with an on-site automated external defibrillator use protective against SD (P =.01). Conclusions Survival from commotio cordis has increased, likely owing to more rapid response times and access to defibrillation, as well as greater public awareness of this condition.

Original languageEnglish (US)
Pages (from-to)219-223
Number of pages5
JournalHeart Rhythm
Volume10
Issue number2
DOIs
StatePublished - Jan 1 2013

Fingerprint

Commotio Cordis
Survival Rate
Sudden Death
Sports
Survivors
Defibrillators
Survival
Mortality
Ventricular Fibrillation
Heart Arrest
Resuscitation
African Americans
Reaction Time
Registries
Cause of Death

Keywords

  • Commotio cordis
  • Defibrillation
  • Sudden death
  • Trauma
  • Ventricular fibrillation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Maron, B. J., Haas, T. S., Ahluwalia, A., Garberich, R. F., Mark Estes, N. A., & Link, M. S. (2013). Increasing survival rate from commotio cordis. Heart Rhythm, 10(2), 219-223. https://doi.org/10.1016/j.hrthm.2012.10.034

Increasing survival rate from commotio cordis. / Maron, Barry J.; Haas, Tammy S.; Ahluwalia, Aneesha; Garberich, Ross F.; Mark Estes, N. A.; Link, Mark S.

In: Heart Rhythm, Vol. 10, No. 2, 01.01.2013, p. 219-223.

Research output: Contribution to journalArticle

Maron, BJ, Haas, TS, Ahluwalia, A, Garberich, RF, Mark Estes, NA & Link, MS 2013, 'Increasing survival rate from commotio cordis', Heart Rhythm, vol. 10, no. 2, pp. 219-223. https://doi.org/10.1016/j.hrthm.2012.10.034
Maron BJ, Haas TS, Ahluwalia A, Garberich RF, Mark Estes NA, Link MS. Increasing survival rate from commotio cordis. Heart Rhythm. 2013 Jan 1;10(2):219-223. https://doi.org/10.1016/j.hrthm.2012.10.034
Maron, Barry J. ; Haas, Tammy S. ; Ahluwalia, Aneesha ; Garberich, Ross F. ; Mark Estes, N. A. ; Link, Mark S. / Increasing survival rate from commotio cordis. In: Heart Rhythm. 2013 ; Vol. 10, No. 2. pp. 219-223.
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abstract = "Background Commotio cordis events due to precordial blows triggering ventricular fibrillation are a cause of sudden death (SD) during sports and also daily activities. Despite the absence of structural cardiac abnormalities, these events have been considered predominantly fatal with low survival rates. Objective To determine whether expected mortality rates for commotio cordis have changed over time, associated with greater public visibility. Methods US Commotio Cordis Registry was accessed to tabulate frequency of reported SD or resuscitated cardiac arrest over 4 decades. Results At their commotio cordis event, 216 study patients were 0.2–51 years old (mean age 15±9 years); 95{\%} were males. Death occurred in 156 individuals (72{\%}), while the other 60 (28{\%}) survived. Proportion of survivors increased steadily with concomitant decrease in fatal events. For the initial years (1970–1993), 6 of 59 cases survived (10{\%}), while during 1994–2012, 54 of 157 (34{\%}) survived (P =.001). The most recent 6 years, survival from commotio cordis was 31 of 53 (58{\%}), with survivor and nonsurvivor curves ultimately crossing. Higher survival rates were associated with more prompt resuscitation (40{\%}<3 minutes vs 5{\%}>3 minutes; P<.001) and participation in competitive sports (39{\%} P<.001), but with lower rates in African Americans (1 of 24; 4{\%}) than in whites (54 of 166; 33{\%} P =.004). Independent predictors of mortality were black race (P =.045) and participation in noncompetitive sports (P =.002), with an on-site automated external defibrillator use protective against SD (P =.01). Conclusions Survival from commotio cordis has increased, likely owing to more rapid response times and access to defibrillation, as well as greater public awareness of this condition.",
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N2 - Background Commotio cordis events due to precordial blows triggering ventricular fibrillation are a cause of sudden death (SD) during sports and also daily activities. Despite the absence of structural cardiac abnormalities, these events have been considered predominantly fatal with low survival rates. Objective To determine whether expected mortality rates for commotio cordis have changed over time, associated with greater public visibility. Methods US Commotio Cordis Registry was accessed to tabulate frequency of reported SD or resuscitated cardiac arrest over 4 decades. Results At their commotio cordis event, 216 study patients were 0.2–51 years old (mean age 15±9 years); 95% were males. Death occurred in 156 individuals (72%), while the other 60 (28%) survived. Proportion of survivors increased steadily with concomitant decrease in fatal events. For the initial years (1970–1993), 6 of 59 cases survived (10%), while during 1994–2012, 54 of 157 (34%) survived (P =.001). The most recent 6 years, survival from commotio cordis was 31 of 53 (58%), with survivor and nonsurvivor curves ultimately crossing. Higher survival rates were associated with more prompt resuscitation (40%<3 minutes vs 5%>3 minutes; P<.001) and participation in competitive sports (39% P<.001), but with lower rates in African Americans (1 of 24; 4%) than in whites (54 of 166; 33% P =.004). Independent predictors of mortality were black race (P =.045) and participation in noncompetitive sports (P =.002), with an on-site automated external defibrillator use protective against SD (P =.01). Conclusions Survival from commotio cordis has increased, likely owing to more rapid response times and access to defibrillation, as well as greater public awareness of this condition.

AB - Background Commotio cordis events due to precordial blows triggering ventricular fibrillation are a cause of sudden death (SD) during sports and also daily activities. Despite the absence of structural cardiac abnormalities, these events have been considered predominantly fatal with low survival rates. Objective To determine whether expected mortality rates for commotio cordis have changed over time, associated with greater public visibility. Methods US Commotio Cordis Registry was accessed to tabulate frequency of reported SD or resuscitated cardiac arrest over 4 decades. Results At their commotio cordis event, 216 study patients were 0.2–51 years old (mean age 15±9 years); 95% were males. Death occurred in 156 individuals (72%), while the other 60 (28%) survived. Proportion of survivors increased steadily with concomitant decrease in fatal events. For the initial years (1970–1993), 6 of 59 cases survived (10%), while during 1994–2012, 54 of 157 (34%) survived (P =.001). The most recent 6 years, survival from commotio cordis was 31 of 53 (58%), with survivor and nonsurvivor curves ultimately crossing. Higher survival rates were associated with more prompt resuscitation (40%<3 minutes vs 5%>3 minutes; P<.001) and participation in competitive sports (39% P<.001), but with lower rates in African Americans (1 of 24; 4%) than in whites (54 of 166; 33% P =.004). Independent predictors of mortality were black race (P =.045) and participation in noncompetitive sports (P =.002), with an on-site automated external defibrillator use protective against SD (P =.01). Conclusions Survival from commotio cordis has increased, likely owing to more rapid response times and access to defibrillation, as well as greater public awareness of this condition.

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