Dr. Larry Creswell recently wrote a blog post summarizing the excellent research work that he and his colleagues have conducted to better understand the causes and conditions of death during triathlon events.

They have identified all triathlon fatalities that occurred during a 31-year period (1985-2016) and analyzed as many of the relevant factors as possible.  Their work was published in the journal Annals of Internal Medicine.

They observed the following:

• Average age was 47 with a wide range, but the risk of death increases dramatically with age.
• Most victims were male (85%).  This is also the case among marathon fatalities, as we saw previously.
• About 40% of victims were fist time participants, and none of them were elite triathletes.
• Almost 75% of fatalities occurred during the swim event, frequently within the first few minutes.  No specific swimming condition (e.g., water temperature) could be identified.
• Many of the biking segment deaths were traumatic in nature.

In many cases of non-traumatic death, preexisting heart or vascular disease was discovered at autopsy.  The article notes that:

“A surprising and important observation of this investigation, on the basis of autopsy reports, was the high frequency of clinically silent cardiac abnormalities (present in about 50% of the cases with an autopsy report available) that may have caused or contributed to sudden cardiac death.”

Dr. Creswell recommends that athletes should consider their heart health before participating.  Middle-aged men in particular should consider undergoing cardiovascular screening ahead of the event.  Read his excellent blog here.

-Dr. Accad

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