PMID- 32187395 OWN - NLM STAT- MEDLINE DCOM- 20201125 LR - 20201125 IS - 1600-0838 (Electronic) IS - 0905-7188 (Linking) VI - 30 IP - 7 DP - 2020 Jul TI - Pre-race screening and stratification predicts adverse events-A 4-year study in 29585 ultra-marathon entrants, SAFER X. PG - 1205-1211 LID - 10.1111/sms.13659 [doi] AB - BACKGROUND: Pre-race screening and risk stratification in recreational endurance runners may predict adverse events (AEs) during a race. AIM: To determine if pre-race screening and risk stratification predict AEs during a race. METHODS: A total of 29 585 participants (Male 71.1%, average age = 42.1 years; Female 28.9%, average age = 40.2 years) at the Two Oceans ultra-marathon races (56 km) completed a pre-race medical screening questionnaire and were risk stratified into four pre-specified groups [very high risk (VHR; existing cardiovascular disease-CVD:3.2%), high risk (HR; risk factors for CVD:10.5%), intermediate risk (IR; existing other chronic disease, medication use or injury:53.3%), and low risk (LR:33.0%)]. Race starters, finishers, and medical encounters (ME) were recorded. Did-not-start (DNS) rate (per 1000 entrants that did-not-start), did-not-finish (DNF) rate (per 1000 starters that did-not-finish), AE rate [per 1000 starters that either DNF or had an ME], and ME rate (per 1000 starters with an ME) were compared across risk categories. RESULTS: Adverse events were significantly higher (per 1000 starters; 95%CI) in the VHR (68.9; 52.4-89.9:P = .0407) compared with the LR (51.3; 46.5-56.7). The DNS rate was significantly different between the IR (190.3; 184.0-196.9) and LR (207.4; 199.2-216.0: P = .0011). DNF rates were not different in the VHR (56.4; 41.9-75.9) compared to LR (44.2; 39.7-49.1: P = .1295), and ME rate was also not different between risk categories, however, VHR (12.9; 7.0-23.9) was approaching significance compared to LR (6.9; 5.2-9.1: P = .0662). CONCLUSION: Pre-race medical screening and risk stratification may identify athletes at higher risk of AEs. Further studies should be performed in larger cohorts to clarify the role of pre-race medical screening in reducing AEs in endurance runners. CI - (c) 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd. FAU - Sewry, Nicola AU - Sewry N AUID- ORCID: 0000-0003-1022-4780 AD - Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa. AD - International Olympic Committee (IOC) Research Centre, Cape Town, South Africa. FAU - Schwellnus, Martin AU - Schwellnus M AUID- ORCID: 0000-0003-3647-0429 AD - Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa. AD - International Olympic Committee (IOC) Research Centre, Cape Town, South Africa. AD - Emeritus Professor of Sport and Exercise Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa. FAU - Borjesson, Mats AU - Borjesson M AD - Institute of Neuroscience and Physiology, Sahlgrenska Academy, Goteborg University, Gothenburg, Sweden. AD - Center for Health and Performance, Goteborg University, Gothenburg, Sweden. AD - Sahlgrenska University Hospital/Ostra, Goteborg, Sweden. FAU - Swanevelder, Sonja AU - Swanevelder S AD - Biostatistics Unit, South African Medical Research Council, Cape Town, South Africa. FAU - Jordaan, Esme AU - Jordaan E AD - Biostatistics Unit, South African Medical Research Council, Cape Town, South Africa. AD - Statistics and Population Studies Department, University of the Western Cape, Cape Town, South Africa. LA - eng GR - IOC Research Center (South Africa) (partial funding), Medical Research Council (partial funding, statistical analysis)/ PT - Journal Article DEP - 20200403 PL - Denmark TA - Scand J Med Sci Sports JT - Scandinavian journal of medicine & science in sports JID - 9111504 SB - IM MH - Adult MH - Athletes/*classification MH - Cardiovascular Diseases/*diagnosis MH - Cross-Sectional Studies MH - Female MH - Forecasting MH - Humans MH - Male MH - *Mass Screening MH - Prospective Studies MH - Risk Factors MH - *Running MH - Surveys and Questionnaires OTO - NOTNLM OT - SAFER study OT - epidemiology OT - medical screening OT - pre-race screening OT - risk stratification OT - running EDAT- 2020/03/19 06:00 MHDA- 2020/11/26 06:00 CRDT- 2020/03/19 06:00 PHST- 2019/10/09 00:00 [received] PHST- 2020/02/17 00:00 [revised] PHST- 2020/03/10 00:00 [accepted] PHST- 2020/03/19 06:00 [pubmed] PHST- 2020/11/26 06:00 [medline] PHST- 2020/03/19 06:00 [entrez] AID - 10.1111/sms.13659 [doi] PST - ppublish SO - Scand J Med Sci Sports. 2020 Jul;30(7):1205-1211. doi: 10.1111/sms.13659. Epub 2020 Apr 3.