Cardiac Arrest Care on United States Golf Courses-Up to Par Yet?

Document Type

Article

Publication Date

2-1-2026

Publication Title

J Am Coll Emerg Physicians Open

Abstract

UNLABELLED: Out-of-hospital cardiac arrest (OHCA) is a significant public health issue with a < 10% survival rate. Although exercise is beneficial for cardiovascular health, it is also associated with increased risk of OHCA during and immediately after exertion. Golf courses present the fifth most frequent location for OHCA in public settings. Bystander interventions, such as cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) use, are crucial for improving survival rates. Despite recommendations from organizations like the Professional Golfers' Association of America recommending AEDs at golfing facilities, AED availability and utilization on golf courses prior to Emergency Medical Services arrival remain unknown.

OBJECTIVES: This investigation aimed to determine the incidence of OHCA on golf courses and to examine patient demographics, event and golf course characteristics, and their association with bystander CPR provision, AED use, and survival outcomes.

METHODS: This retrospective study utilized data from the Cardiac Arrest Registry to Enhance Survival from 2020 to 2023. Addresses of cardiac arrests in recreational facilities were spatially linked to a comprehensive list of golf course addresses using ArcGIS. Cases identified as occurring in a recreational location, within 400 m of both the incident address and a nearby golf course, were included in the analysis. The primary outcome was the frequency of bystander interventions for either CPR or AED use. Secondary outcomes included survival to hospital admission and discharge, and a favorable neurologic outcome (cerebral performance category 1 or 2). Descriptive statistics and univariate analyses were employed to examine patient demographics, golf course characteristics, bystander interventions, and patient outcomes. Multivariable regression analysis was also used to assess these associations.

RESULTS: A total of 476 OHCA cases were identified on golf courses during the study period. The patients were predominantly male (91.4%,

CONCLUSION: Patients experiencing OHCA on golf courses frequently receive bystander interventions, including both CPR and AED use. OHCA patients on golf courses had high survival rates and excellent neurologic outcomes. This study underscores the benefit of, and critical need for, initiatives promoting CPR and AED resources, as well as comprehensive CPR training and rapid response protocols at golf courses.

Volume

7

Issue

1

First Page

100278

Last Page

100278

DOI

10.1016/j.acepjo.2025.100278

ISSN

2688-1152

PubMed ID

41377479

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