Epidemiology of Sudden Death in Organized Youth Sports in the United States, 2007-2015

Endres BD, Kerr ZY, Stearns RL, Adams WM, Hosokawa Y, Huggins RA, Kucera KL, Casa DJ. Journal of Athletic Training. 2019;54(4):349–355

Full Text Freely Available

Take Home Message: During the years 2007-2015, there were 45 sudden deaths among youth sport athletes (middle school, youth leagues, recreational sports). Sudden deaths were typically cardiac related (76%) and most common among males or basketball players and during practice (71%).

In the year 2015 alone, more than 28 million youth athletes between the ages of 6 and 17 years participated in sports. While researchers have extensively studied sudden death in athletics in high school or collegiate populations, little is known about sudden death among individuals who compete in youth sports outside of the high school setting. Therefore, Endres and colleagues described the epidemiology of sudden death among athletes aged 6 to 17 years participating in organized middle school, youth league, or recreational sports in the United States. The authors collected data from news and media reports using LexisNexis Academic Database and internet searches. Athlete participation was quantified using data from the Sport & Fitness Industry Association. The authors defined participation in athlete-years, which was 1 youth athlete participating in 1 sport in a calendar year. Overall, 45 youth athletes had sudden deaths from 2007 through 2015 during participation in organized youth sports. Most cases of sudden death occurred in males (80%), during practice (71%), or in the middle school setting (58%). Seventy-six percent of sudden deaths were cardiac-related. The second most frequent cause of sudden death was traumatic brain injury (7%) followed by blunt force trauma (4%). Most deaths occurred in basketball (36%) followed by baseball (16%), football (16%), and soccer (13%). The overall incidence of sudden death from 2007 through 2015 was almost 2 deaths per 10 million athlete-years.

This study is important because it offers a glimpse at how often sudden death occurs and who is at risk among youth athletes that are often lacking access to medical resources (e.g., AEDs, athletic trainers, comprehensive medical screening). Sudden cardiac death was the number one cause of sudden death among youth athletes in this study. This is consistent with previous literature examining high school and collegiate athletes. This is of particular concern as sudden cardiac death often has no warning signs or symptoms and occurs abruptly. Without access to rapid medical care and early defibrillation, cardiac events carry a great chance of becoming fatal. These new findings should be used to advocate for appropriate medical care (e.g., athletic trainers) and medical equipment (e.g., AED) to be readily available for youth athletes participating in sport. This may be easiest to implement in the middle school setting because school boards and superintendents are familiar with the medical care needed for high school athletes. A disproportionate amount of sudden deaths occurred in males and during basketball. This complements previous research showing that males, especially males of African-American descent, are more likely to suffer sudden death. Based on these results, we need to continue surveillance of sudden death at all levels of sport, develop and assess evidence-based policies aimed at preventing sudden death in sport, and advocate for middle schools, youth leagues, and recreational teams to take steps to ensure the safety of their athletes.

Questions for Discussion: How many middle school or youth sport athletes have immediate access to medical care during sport participation? Do you think there are other variables at play when it comes to sudden death in youth athletes?

Written by: Ian McGinnis

Reviewed by: Jeffrey Driban

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