Strategies for assessing the prevalence of cardiovascular sudden deaths in young competitive athletes

Abstract

Background/objectives: Prevalence/incidence of sudden death due to cardiovascular disease in young competitive athletes has become an important part of the debate over the most effective and practical preparticipation screening strategies for this population. Since event reporting is not mandatory, identification of cases has been achieved largely through publicly available data and internet searches. The accuracy of this methodology has not been studied and deserves scrutiny.

Methods: We assessed recognition of sudden cardiovascular deaths in college (NCAA) athletes with the U.S. National Registry of Sudden Death in Athletes that uses largely public domain sources, and also the NCAA Memorial Resolutions List.

Results: For 2002-2011, 64 total sudden death cases were identified by both sources. The Registry identified 56 cases (88%), including 14 not found in the NCAA List. The NCAA List identified 50 cases (78%), including 8 unrecognized by the Registry (p=0.16). Failure to initially recognize these 8 deaths using established Registry search mechanisms was due to the absence of key search terms in media reports. Cases not identified by the 2 methodologies did not differ significantly regarding demographics, cause of death, or sport.

Conclusions: Internet-based, public domain methodology is useful and identified more cases of sudden cardiovascular death in college athletes than did the internal list provided by the NCAA. Nevertheless, these findings support the principle that multiple sources are additive and beneficial in identifying the maximum number of sudden death events.

Keywords: Athletes; Hypertrophic cardiomyopathy; Sudden death.