Sudden cardiac arrest due to commotio cordis occurs more frequently in non-sport-related settings than is commonly thought, resulting in lower rates of resuscitation and increased mortality, especially among young women, a new review suggests.
Lim and colleagues searched the literature through 2021 for all cases of commotio cordis. Three hundred and thirty-four cases from among 53 citations were included in the analysis; of those, 121 occurred in non-sport-related settings, including assault , MVAs , and daily activities ."Daily activities" comprised activities that were expected in a person's day-to-day routine such as falls, playfighting , and occupational accidents.
Sport-related cases involved a significantly higher proportion of projectiles and occurred across a range of sports, mostly at the competitive level . However, in non-sport-related events, the proportion of females affected was significantly higher , as was mortality . Rates were lower for CPR and defibrillation use , and resuscitation was more commonly delayed beyond 3 minutes .
Study limitations included the use of data only from published studies, inclusion of a case series limited to fatal cases, small sample sizes, and lack of consistent reporting of demographic data, mechanisms, investigation results, management, and outcomes.Lim and colleagues conclude that increased awareness of non-sport-related commotio cordis is"essential" for early recognition, resuscitation, and mortality reduction.
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