Why Ghanaian Footballers Need Training in CPR: The Case Study of Erikson.

Though we do not yet know what caused Christian Eriksen to collapse during the recent football match between Denmark and Finland in the ongoing Euro 2020, there are many lessons we learnt from this scenario. One could see how Medical Staff were quick to attend to him while his teammates, opposition and coaching staff were visibly stricken by the scenes unfolding at the Parken Stadium.

But this is not the first time such a situation has occurred. For football lovers, many will remember the collapse of Bolton Wanderers star Fabrice Muamba in 2012. We look at the incidence of these events in sporting activities and propose possible policy direction.

One article in the Guardian, (2012) found that more than 80 footballers have died suddenly while playing, all young men, all otherwise apparently fit and healthy.

Incidence of Sports Sudden Cardiac Death

We reviewed some studies on this as health policy researchers. One study conducted by Higgins & Andino (2013) places the incidence of Sudden Cardiac Death (SCD) at 1-2/100,000 per year, with athletes at 2.5 times higher risk.

A previous study by Kramer et al., (2010) also revealed an incidence rate of 1:65,000 to 1:200,000 athletes in USA. Harmon and Drezner, (2007) equates this to 1 Sudden Cardiac Arrest every 3 days. Corrado et al., (2003) also found Cardiac Arrest to be 2.5 times higher in athletes than in non-athletes. A similar prospective population-based study by Corrado et al.,(2005) in the Vento Region of Italy reported 2.3 per 100,000 athletes per year die from all causes, while 2.1 per 100 000 athletes per year die from cardiovascular diseases^.

A more recent study by Malhotra et al., (2018) in the United Kingdom also screened 11,168 adolescent athletes with a mean age of 16 years (95% of whom were male) in the English Football Association (FA) cardiac screening program, which consisted of a health questionnaire, physical examination, electrocardiography, and echocardiography from 1996 to 2016. The study found 42 athletes (0.38%) to have cardiac disorders that are associated with sudden cardiac death. Post screening, there were 23 deaths from any cause, of which 8 (35%) were sudden deaths attributed to cardiac disease. The mean time between screening and sudden cardiac death was 6.8 years. On the basis of a total of 118,351 person-years, the incidence of sudden cardiac death among previously screened adolescent soccer players was 1 per 14,794 person-years (6.8 per 100,000 athletes).

Another study in Spain by Suárez-Mier and Aguilera, (2002), reviewed cases during sports activities from 1995 to 2001 in the registries of the Institute of Toxicology of Madrid, (Ministry of Justice). The series included 61 cases ranging in age from 11 to 65 years; 59 males and 2 females. The sports most frequently involved were cycling (21), football (13), and gymnastics (5).

In Croatia, a study by Duraković et al., (2012) which covers the period of 27 years: from January 1, 1984 to December 31, 2010 noticed 69 sudden and unexpected cardiac deaths during physical exercise in Croatia.

A more recent study by Leonid Makarov (2020), conducted between 1980 and 2011 in Sudden Death among Young Athletes Registry in the USA, recorded 2406 observed in 29 diverse sports. The study found 80% of all Sudden Death occurred in high school/middle school or collegiate student athletes, and 20% were engaged in organized youth, postgraduate.

Statistical data vary greatly in different countries: Sudden Cardiac Death incidence rate in the USA is 7.47 and 1.33 per 1,000,000 exercising male and female school-age athletes respectively, whereas in Italy, the rate is 2.6 cases in men and 1.1 in women per 100,000 individuals per year who are involved in active competitive sports. The European Heart Rhythm Association (EHRA) position paper concluded that as an overall estimate, 1–2 out of 100,000 athletes between of age of 12 and 35 years old die suddenly each year.

Policy framework

We propose the following to the Ghana Football Association(GFA) and Ministry of Youth and Sports, as athletes are more likely to experience sudden cardiac arrest during racing, soccer, hockey from per studies:

The writers, Dr. Raphael Nyarkotey Obu is the President of Nyarkotey College of Holistic Medicine and Lawrencia Aggrey –Blewuy is an Assistant Lecturer at the Department of Health Policy, University of Education.