{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T08:33:18Z","timestamp":1793089998174,"version":"4.5.0"},"reference-count":21,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:00:00Z","timestamp":1791936000000},"content-version":"vor","delay-in-days":286,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["JP17K09132"],"award-info":[{"award-number":["JP17K09132"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["JP20K10537"],"award-info":[{"award-number":["JP20K10537"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["JP24K13487"],"award-info":[{"award-number":["JP24K13487"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acute Medicine &amp;amp; Surgery"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>To describe the characteristics and outcomes of sports\u2010related out\u2010of\u2010hospital cardiac arrest (OHCA) due to external causes, including commotio cordis, during school\u2010supervised sports activities in Japan's elementary schools, junior high schools, high schools, and technical colleges.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>OHCA data (2008\u20132022) were obtained from the Stop and Prevent cardIac aRrest, Injury, and Trauma in Schools (SPIRITS)\u2014a nationwide database of OHCAs occurring under school supervision across Japan. We identified sports\u2010related OHCAs with external causes and summarized patients' characteristics, bystander interventions, available response intervals, and survival outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We identified 30 sports\u2010related OHCA cases due to external causes. The most frequently played sports were soccer\/futsal (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20098), baseball (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20098), and swimming (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20094). The leading etiology was commotio cordis (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200915), followed by drowning (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20098). Among the 15 cases meeting our operational definition of commotio cordis, automated external defibrillator (AED) pads were applied in 14 (93%), shocks were delivered in 13 (87%), and 12 (80%) achieved a favorable neurological outcome. Among other external causes (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200915), ventricular fibrillation occurred in 4\/15 (27%), AED pads were applied in 7\/15 (47%), shocks were rare (1\/15, 7%), and 1\/15 (7%) achieved favorable neurological outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Nationwide case\u2010level reconstruction revealed distinct mechanism\u2010to\u2010response pathways. Although these descriptive data cannot establish the causal effects of the public access defibrillation programs or other interventions on outcomes, they highlight potentially actionable, mechanism\u2010specific opportunities for emergency response and prevention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ams2.70168","type":"journal-article","created":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T07:42:58Z","timestamp":1791963778000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Sports\u2010Related Out\u2010of\u2010Hospital Cardiac Arrest due to External Causes, Including Commotio Cordis, at Schools in Japan"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0644-6129","authenticated-orcid":false,"given":"Kosuke","family":"Kiyohara","sequence":"first","affiliation":[{"name":"Department of Food Science, Faculty of Home Economics Otsuma Women's University  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3684-1496","authenticated-orcid":false,"given":"Mamoru","family":"Ayusawa","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Health Science, Faculty of Health and Medical Science Kanagawa Institute of Technology  Atsugi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6886-9306","authenticated-orcid":false,"given":"Masahiko","family":"Nitta","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Osaka Medical and Pharmaceutical University  Osaka Japan"},{"name":"Department of Pediatrics Osaka Medical and Pharmaceutical University  Osaka Japan"},{"name":"Division of Patient Safety Osaka Medical and Pharmaceutical University Hospital  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taku","family":"Iwami","sequence":"additional","affiliation":[{"name":"Department of Preventive Services Kyoto University School of Public Health  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ken","family":"Nakata","sequence":"additional","affiliation":[{"name":"Medicine for Sports and Performing Arts, Department of Health and Sports Sciences, Graduate School of Medicine The University of Osaka  Suita Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7665-3524","authenticated-orcid":false,"given":"Yuri","family":"Kitamura","sequence":"additional","affiliation":[{"name":"Division of Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Graduate School of Medicine The University of Osaka  Suita Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0107-0580","authenticated-orcid":false,"given":"Tetsuhisa","family":"Kitamura","sequence":"additional","affiliation":[{"name":"Division of Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Graduate School of Medicine The University of Osaka  Suita 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