Leisure athletes at risk of medical complications: outcomes of pre-participation screening among 15778 endurance runners - SAFER VII
Objective: International guidelines for pre-participation screening of masters/leisure athletes to identify those that require medical assessment exist, but have not been implemented in mass-community based sports events. We determined the prevalence of runners who, according to these guidelines, would require a medical assessment before participating in a distance running event.
Methods: Participants of the 2012 Two Oceans races (21.1 and 56km) in South Africa (n=15778) completed an online pre-race medical screening questionnaire using European pre-participation screening guidelines. We determined the prevalence of runners that would require a pre-race medical assessment, based on risk factors, symptoms and disease.
Results: The pre-participation “self assessment of risk” screening identified 4941 runners (31.3%; 95% CI 30.6-32.0) that would need to undergo a full pre-participation medical assessment prior to running, if the current pre-participation screening guidelines are applied. Although musculoskeletal complaints and prescription medication use were the main triggers for a medical assessment, 16.8 % (n=2657) runners should undergo medical evaluation for suspected cardiac disease based on the questionnaire results: 3.4% (n=538) reporting existing CVD (very high risk) and 13.4% (n=2119) reporting multiple CVD risk factors (high risk). Other possible risk factors were reported as follows: history of chronic diseases (respiratory = 13.1%, gastro-intestinal = 4.3%, nervous system = 3.8%, metabolic/endocrine = 3.5%, allergies = 13.9%); chronic prescription medication = 14.8%, used medication before or during races = 15.6%; past history of collapse during a race = 1.4%.
Conclusions: Current guidelines identified that >30% runners would require a full medical assessment before race participation - mainly linked to runners reporting musculoskeletal conditions. We suggest a revision of guidelines and propose that pre-race screening should be considered to identify runners with a “very high”, “high” and “intermediate risk” for medical complications during exercise. Pre-race screening and educational intervention could be implemented to reduce medical complications during exercise.
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Autor / Fonte:Karen Schwabe, Martin Schwellnus, Sonja Swanevelder, Esme Jordaan, Wayne Derman, Andrew Bosch Physician and Sportsmedicine 2018 July 27