Study Finds That Sudden Death in Middle School Age Student Athletes Most Common While Playing Basketball

National Athletic Trainers’ Association and National Basketball Athletic Trainer Association Provide Tips for Parents to Help Keep Their Student Athlete Safe

DALLAS, TX--The majority of sudden death in American youth sports (ages 6-17) from 2007-2015 were cardiac-related (heart) and occurred during practice within organized middle school sports according to a first-of-its-kind study published in the National Athletic Trainers’ Association (NATA) Journal of Athletic Training. The majority of those affected were male with an average age of 13 years old. No previous studies have focused on sudden death in organized middle school, youth, and recreational youth sports in the United States.

Key Definitions

  • Sudden Cardiac Arrest (SCA) – a condition in which the heart unexpectedly stops beating, which stops blood flow to the brain and other vital organs and results in death if not treated within minutes.
  • Sudden Cardiac Death (SCD) – a sudden, unexpected death caused by a change in heart rhythm.

Key Statistics

  • From 2007 to 2015, sudden cardiac death (SCD) accounted for 76% of the total deaths in youth sports. Basketball accounted for the largest proportion (36%), followed by baseball (16%), American football (16%), and soccer (13%).
  • 73% of sudden deaths occurred among individuals aged 12 to 14 years.
  • More than two-thirds of sudden deaths occurred during practices.
  • Four out of five sudden deaths affected males.
  • The incidence of sudden cardiac arrest (SCA) has been previously shown to be higher among African American males than among males of other races and ethnicities. 1,2,3
  • 58% of sudden deaths occurred in organized middle school sports.
  • From 2007 to 2015, 45 sudden deaths were reported in American youth sports
  • New York reported the largest number of sudden deaths, followed by Illinois, California, Georgia and New Jersey.

The research titled Epidemiology of Sudden Death in Organized Youth Sports in the United States, 2007–2015 was led by researchers from the Korey Stringer Institute (KSI) at the University of Connecticut and focused on three unique settings for youth sports: middle schools, organized youth sports leagues and clubs (a $5 billion industry4) and recreational youth sport events. More than 58% of sudden deaths occurred in organized middle school sports, whereas 40% of affected athletes participated in recreational and youth sport leagues. The findings are similar to previous studies that evaluated sudden death in high school and collegiate sports as well as with older athletes. Study authors gathered data from research databases, internet searches and other published news reports and did not focus on organized high school sports since sudden death among this population has been discussed extensively.

“Until this study, sudden deaths occurring in youth sport had been grouped with sudden deaths occurring in older athletic populations in previous epidemiological studies,” said Brad Endres, MS, ATC, Assistant Director of Sport Safety at KSI and lead author of the study. “Our goal was to clearly define the understanding of ‘youth sport’ so that more appropriate and evidence-based policy decisions aimed at improving youth sport safety can be implemented.”

  • Middle schools traditionally operate as part of a school distract and may be the most likely youth sport settings to adopt policies and procedures that have also been implemented at the high school level.
  • Organized youth sport leagues are largely coordinated and maintained by nonprofit groups with highly variable sport safety policies, procedures and oversight.
  • Recreational youth sport events usually have the least amount of oversight and are often made up of athletes who want to take part of an individual event or the sport as part of a hobby or for leisure.

“While high school and college sports usually get the spotlight when it comes to the prevention of catastrophic health and injury events, this study confirms the need to extend best practices and policies to the youth and recreational levels to protect all young athletes, “said NATA President, Tory Lindley, MA, ATC. “Reports from the Korey Stringer Institute tells us that sudden cardiac death is one hundred percent preventable. Yet it is still a leading cause of sudden death. It is incumbent on middle schools, organized and recreational sports programs to put the health and safety of participant’s first.”

“Athletic trainers in the NBA care for professional basketball players, who were once kids with dreams of competing at the highest level of their sport,” said National Basketball Athletic Trainers’ Association Chairman, Joe Sharpe, ATC, LAT. “Children should be able to play basketball – or any sport for that matter – with an assurance that appropriate medical care is available and lifesaving best practices are in place. 

Here are five tips from NATA and NBATA for parents to help keep their student athlete healthy while playing basketball.

  1. Get a checkup before play. Ensure that your athlete has completed a pre-participation evaluation (PPE) with a medical professional who is trained and comfortable with detection of cardiovascular (heart) problems before they start practice, even if it’s not mandatory. PPEs are a screening tool used by athletic trainers, physicians and others in the sports medicine community to help identify conditions that may make it more likely that an athlete will get injured or be at risk for sudden death.
  2. Ask about the coach. While the coach should certainly have a background and knowledge in the sport they are coaching and be credentialed, if required in your state, conference, or league, they should also strictly enforce rules. It is equally important that they create a culture of safety and openness so players feel safe to report injuries and receive the appropriate medical attention.
  3. Ask about emergency plans. Ask if there is a venue-specific emergency action plan (EAP), which outlines exactly what to do and who to call in case of an emergency. At home or on the road, every team should be able to easily access a venue-specific written EAP reviewed by an athletic trainer or local emergency medical service.
  4. Get a CPR/AED certified person at every practice and game. Know where the nearest automated external defibrillator (AED) is located and ask if there is someone certified in CPR, AED and first aid at every practice and game. If the answer is no, advocate for that role immediately. When CPR is provided and an AED shock is administered within the first three to five minutes after a collapse, survival rates are as high as 74%. Time plays a critical factor in surviving a cardiac arrest event, so it’s vital that there is someone trained who can immediately and confidently jump into action.
  5. Ask if there is an athletic trainer. Have a medical professional such as an athletic trainer on-hand at every practice and game. They not only prevent, diagnose, treat and rehabilitate injuries, but are trained in emergency injury, illness and cardiac care.

“By putting these tips into play, parents can help keep young athletes safe and reduce the risk of injury or fatality,” added Lindley.

For more information and resources, visit At Your Own Risk.

1Harmon KG, Asif IM, Maleszewski JJ, et al. Incidence and etiology of sudden cardiac arrest and death in high school athletes in the United States. Mayo Clin Proc. 2016;91(11):1493–1502

2Harmon KG, Asif IM, Maleszewski JJ, et al. Incidence, cause, and comparative frequency of sudden cardiac death in National Collegiate Athletic Association athletes: a decade in review. Circulation. 2015;132(1):10–19.

3Harmon KG, Drezner JA, Wilson MG, Sharma S. Incidence of sudden cardiac death in athletes: a state-of-the-art review. Br J Sports Med. 2014;48(15):1185–1192

4 Kelley B, Carchia C. Hidden Demographics of Youth Sports. ESPN.com Web site. http://www.espn.com/espn/story/_/id/ 9469252. Accessed March 4, 2017

SOURCE: NATA

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