No One Left Behind: Incidence of Sudden Cardiac Arrest and 30-Day Survival in Military Members

Objectives: Military service requires intense exercise, increasing the risk of sudden cardiac arrest, which is typically fatal without bystander cardiopulmonary resuscitation (CPR) combined with immediate defibrillation. Out-of-hospital cardiac arrest survival rates average 10%. The US military emphasizes team responsibility for providing immediate rescue to individual members. Data suggest that CPR and bystander defibrillation rates are higher on military bases than off bases. We hypothesized that sudden cardiac arrest rates would be greater in the military, but survival posthospitalization would be better than in civilian cohorts. Methods: The Military Health System Data Repository was queried from fiscal years 2016-2019 for the diagnoses of cardiac arrest, torsades de pointes, ventricular fibrillation, and ventricular flutter in a cross-sectional study of actively serving U.S. military members ages 17-64 years. Results: A total of 958 military personnel were identified with sudden cardiac arrest/ventricular arrhythmia from fiscal years 2016 to 2019 with a sudden cardiac arrest rate of 10.8 per 100,000 person-years. Thirty-day survival rates were high at 73% for subjects aged <35 and 76% for those aged 35-64 years. Conclusions: Despite a high incidence of sudden cardiac arrest in the military, survival beyond 30 days for those transported to the hospital was excellent. While greater efforts toward preventing sudden cardiac arrest in the military are indicated, these data suggest that increased rates of bystander CPR and defibrillation result in meaningful gains in survival.