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Title: Commotio Cordis in Non-Sport-Related Events: A Systematic Review.
Austin Authors: Lee, Rafael N;Sampaio Rodrigues, Thalys ;Gan, Joscelyn T;Han, Hui-Chen ;Mansour, Rama;Sanders, Prashanthan;Farouque, Omar ;Lim, Han S 
Affiliation: University of Melbourne Faculty of Medicine, Dentistry and Health Sciences, Melbourne, Victoria, Australia.
Austin Health
South Australia Health and Medical Research Institute, Adelaide, South Australia, Australia; Royal Adelaide Hospital, Adelaide, South Australia, Australia.
Issue Date: Aug-2023
Date: 2023
Publication information: JACC. Clinical Electrophysiology 2023-08; 9(8 Pt 1)
Abstract: Commotio cordis is an increasingly recognized cause of sudden cardiac death. Although commonly linked with athletes, many events occur in non-sport-related settings. The goal of this study was to characterize and compare non-sport-related vs sport-related commotio cordis. PubMed and Embase were searched for all cases of commotio cordis from inception to January 5, 2022. Of 334 commotio cordis cases identified, 121 (36%) occurred in non-sport-related contexts, which included assault (76%), motor vehicle accidents (7%), and daily activities (16%). Projectiles were implicated significantly less in non-sport-related events (5% vs 94%, respectively; P < 0.001). Nonprojectile etiologies in non-sport-related events mostly consisted of impacts with body parts (79%). Both categories affected similar younger aged demographic (P = 0.10). The proportion of female victims was significantly higher in non-sport-related events (13% vs 2%, respectively; P = 0.025). Mortality was significantly higher in non-sport-related events (88% vs 66%, respectively; P < 0.001). In non-sport-related events, rates of cardiopulmonary resuscitation (27% vs 97%, respectively; P < 0.001) and defibrillation (17% vs 81%, respectively; P < 0.001) were both lower and resuscitation was more commonly delayed beyond 3 min (80% vs 5%, respectively; P < 0.001). Commotio cordis occurs across a spectrum of non-sport-related settings including assault, motor vehicle accidents, and daily activities. Both categories affected a younger and male-predominant demographic. Mortality is higher in non-sport-related commotio cordis, likely owing to lower rates of cardiopulmonary resuscitation, defibrillation, automated external defibrillator availability, and extended time to resuscitation. Increased awareness of non-sport-related commotio cordis is essential to develop a means of prevention and mortality reduction, with earlier recognition and prompt resuscitation measures.
DOI: 10.1016/j.jacep.2023.01.010
Journal: JACC. Clinical Electrophysiology
Start page: 1321
End page: 1329
PubMed URL: 37558288
ISSN: 2405-5018
Type: Journal Article
Subjects: commotio cordis
sudden cardiac death
ventricular fibrillation
Commotio Cordis/epidemiology
Commotio Cordis/complications
Death, Sudden, Cardiac/epidemiology
Death, Sudden, Cardiac/etiology
Death, Sudden, Cardiac/prevention & control
Defibrillators/adverse effects
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