Objective To evaluate the provision of bystander interventions and rates of survival after exercise-related sudden cardiac arrest (SCA). Design Systematic review. Data sources MEDLINE, EMBASE, PubMed, CINAHL, SPORTDiscus, Cochrane Library and grey literature sources were searched from inception to November/December 2020. Study eligibility criteria Observational studies assessing a population of exercise-related SCA (out-of-hospital cardiac arrests that occurred during exercise or within 1 hour of cessation of activity), where bystander cardiopulmonary resuscitation (CPR) and/or automated external defibrillator (AED) use were reported, and survival outcomes were ascertained. Methods Among all included studies, the median (IQR) proportions of bystander CPR and bystander AED use, as well as median (IQR) rate of survival to hospital discharge, were calculated. Results A total of 29 studies were included in this review, with a median study duration of 78.7 months and a median sample size of 91. Most exercise-related SCA patients were male (median: 92%, IQR: 86%–96%), middle-aged (median: 51, IQR: 39–56 years), and presented with a shockable arrest rhythm (median: 78%, IQR: 62%–86%). Bystander CPR was initiated in a median of 71% (IQR: 59%–87%) of arrests, whereas bystander AED use occurred in a median of 31% (IQR: 19%–42%) of arrests. Among the 19 studies that reported survival to hospital discharge, the median rate of survival was 32% (IQR: 24%–49%). Studies which evaluated the relationship between bystander interventions and survival outcomes reported that both bystander CPR and AED use were associated with survival after exercise-related SCA. Conclusion Exercise-related SCA occurs predominantly in males and presents with a shockable ventricular arrhythmia in most cases, emphasising the importance of rapid access to defibrillation. Further efforts are needed to promote early recognition and a rapid bystander response to exercise-related SCA.

中文翻译：

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运动相关心脏骤停后的旁观者干预和生存：系统评价

目的评价运动相关心脏骤停（SCA）后旁观者干预措施的提供情况和生存率。设计系统审查。数据来源 MEDLINE、EMBASE、PubMed、CINAHL、SPORTDiscus、Cochrane 图书馆和灰色文献来源从开始到 2020 年 11 月/2020 年 12 月进行了搜索。研究资格标准发生在运动期间或活动停止后 1 小时内），其中报告了旁观者心肺复苏 (CPR) 和/或自动体外除颤器 (AED) 的使用，并确定了生存结果。方法 在所有纳入的研究中，旁观者 CPR 和旁观者 AED 使用的中位数 (IQR) 比例，以及出院生存率中位数 (IQR)，进行了计算。结果 本综述共纳入 29 项研究，中位研究时间为 78.7 个月，中位样本量为 91 个。大多数与运动相关的 SCA 患者为男性（中位数：92%，IQR：86%–96%） ，中年（中位数：51，IQR：39-56 岁），并呈现可休克的停搏节律（中位数：78%，IQR：62%-86%）。旁观者 CPR 在 71% (IQR: 59%–87%) 的逮捕中开始，而旁观者 AED 的使用发生在 31% (IQR: 19%–42%) 的逮捕中。在报告生存至出院的 19 项研究中，中位生存率为 32%（IQR：24%–49%）。评估旁观者干预与生存结果之间关系的研究报告称，旁观者 CPR 和 AED 的使用都与运动相关 SCA 后的生存相关。结论 运动相关性 SCA 主要发生在男性中，并且在大多数情况下表现为可电击的室性心律失常，强调了快速除颤的重要性。需要进一步努力促进对运动相关 SCA 的早期识别和旁观者的快速反应。