Preparticipation Screening May Save Athletes’ Lives

If you train athletes, you may want to know about the validity of prescreening. In 1982, Italy introduced a mandatory nationwide screening process to reduce the incidence of sudden cardiovascular death (SCD) in athletes during competition. The screening process includes a detailed history, a physical exam and an electrocardiogram.

A study published recently in the Journal of the American Medical Association (2006; 269, 1593–1601) set out to discover whether the screening process was proving helpful in saving lives. The study period began in 1979, before screening was introduced, and ended in 2004. Between 1982 and 2004, more than 42,300 athletes ages 12–35 underwent prescreening. Unscreened nonathletes in the same age range served as controls.

Among the unscreened nonathletes, 265 deaths occurred, with no change in death rates after 1982. Among the screened athletes, 55 deaths occurred, with the death rate steadily decreasing after screening was introduced. The
researchers noted an 89% decrease in the annual SCD mortality rate among athletes after the mandatory screening law was introduced. “These data demonstrate the benefit of the current Italian screening program and have
important implications for implementing screening strategies for prevention
of sudden death in athletes in other countries,” study authors wrote.—Ryan Halvorson