Global incidence of sudden cardiac arrest in young athletes and military members: a systematic review and meta-analysis

Objectives The goals of this review are to evaluate the quality of the evidence on epidemiology of SCA/D in athletes and military members; and to synthesize existing data to estimate annual incidence of SCA/D. Design Systematic review and meta-analysis. Data Sources MEDLINE, Embase, Cochrane CENTRAL, Web of Science, BIOSIS, Scopus, SPORT discus, PEDro, were searched from inception to date searched between 2/21/19 and 3/1/19, and Clinicaltrials.gov on 7/29/19. All databases were searched without limits on language. Eligibility for selecting studies Studies which report incidence, or data from which incidence can be calculated, of SCA/D or both in athletes, or military members age 40. Results 40 total studies were included. Overall quality of the evidence was judged to be poor. 35 of 40 included studies reported 1,902 events of SCD over 404,268,083 person years and a pooled incidence rate of 1.39events per 100,000 person years (95% CI: 0.80, 2.43) with high heterogeneity (I 2 =99%). 11 studies reported 219 events of SCA over 13,450,396 person years and a pooled incidence rate of 3.05 events per 100,000 person years (95% CI: 1.42, 6.58) with high heterogeneity (I 2 =96%). Conclusion The worldwide incidence of sudden cardiac death and arrest in young otherwise healthy athletes and military personnel is low. Available subgroup analysis showed incidence rates were highest in males; military members, elite athletes; and soccer athletes. Findings are tempered by unexplained heterogeneity and risk of bias in included studies. PROSPERO Registration: CRD42019125560