Lacrosse Has Highest Death Rate From Ill-Timed Blows To Chest

Sudden deaths due to ill-timed blows to the chest called commotio cordis are more common in the nation's fastest growing sport, lacrosse, than in any other sport, according to a new study in the September 2009 journal, Pediatrics.¹

Higher risk for lacrosse players 

Researchers reviewed 28 years of data in a registry maintained by Minneapolis Heart Institute Foundation on sudden death events among high school and college lacrosse players.

Among the key findings:

• 23 high school and college lacrosse players had sudden-death events between 1980 and 2008;

• Of those 23 athletes

  • 19 died and 4 survived sudden cardiac arrest as a result of CPR and defibrillation;

  • 14 were engaged in sanctioned high school lacrosse; 9 were college lacrosse players;

  • 12 died of previously unsuspected cardiovascular diseases, including hypertrophic cardiomyopathy (HCM). 7 of the 12 had collapsed suddenly and unexpectedly, most consistent with an underlying cardiovascular abnormality.

  • 10 experienced blows to the chest from a lacrosse ball which triggered sudden death or nonfatal cardiac arrest (commotio cordis). Timely defibrillation was performed in 7, with 4 surviving.

  • 4 of the 10 commotio cordis events occurred in goalies, when lacrosse balls propelled at high velocity by opponents attempting shots on goal struck commercially chest protectors directly.

  • The other 6 were struck in the chest by lacrosse balls thrown by other players, including 2 who were in defensive positions and intentionally used their upper body to block shots on goal.

• The mortality risk for lacrosse players as a result of commotio cordis  (.63 deaths per 100,000 person-years) was significantly greater than any other sport except hockey (.53 deaths per 100,000 person-years) and baseball (.24 deaths per 100,000 person-years), even though those sports also employ hard and solid projectiles (e.g. pucks and baseballs).

Recommendations

To reduce the number of commotio cordis deaths in lacrosse, the study's authors suggest:

1. Research and eventual development of a more effective chest protector (preliminary data suggest that such a chest barrier may be most effective when composed of a combination of hard polycarbonate and foam);

2. Making automatic external defibrillators available at all athletic events; and

3. A focused public education campaign.

 

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1.  Maron, B.J. et. al., "Commotio Cordis and the Epidemiology of Sudden Death in Competitive Lacrosse," Pediatrics 124 (3); 976-981, September 2009.

Added August 14, 2009