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1.
Sports Health ; 12(1): 74-79, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31642726

RESUMO

BACKGROUND: Lower extremity overuse injuries are common among runners, especially first-time marathoners. Hip abductor and quadriceps strengthening is often recommended to reduce running-related injuries. HYPOTHESIS: A 12-week strength training program would decrease the rate of overuse injuries resulting in marathon noncompletion and improve race finishing time. STUDY DESIGN: Randomized trial. LEVEL OF EVIDENCE: Level 2. METHODS: Twelve weeks before the New York City Marathon, first-time marathon runners age 18 years and older were randomized into a strength training group or an observation group. The strength training group was instructed to perform a 10-minute program 3 times weekly using written and video instruction. This program targeted the quadriceps, hip abductor, and core muscle groups. Injuries were self-reported through biweekly surveys, with major injuries being those that resulted in marathon noncompletion and minor injuries being those that impaired training or race performance. RESULTS: A total of 720 runners were enrolled (mean age, 35.9 ± 9.4 years; 69.4% female), of whom 583 runners started the marathon and 579 completed it. The incidence of major injury was 8.9% and minor injury was 48.5%. Fifty two of 64 major injuries were overuse, of which 20 were bone stress injuries. The incidence of overuse injury resulting in marathon noncompletion was 7.1% in the strength training group and 7.3% in the observation group (risk ratio, 0.97; 95% CI, 0.57-1.63; P = 0.90). The mean finishing time was 5 hours 1 ± 60 minutes in the strength training group and 4 hours 58 ± 55 minutes in the observation group (P = 0.35). CONCLUSION: There is a high prevalence of injury among first-time marathon runners, but this self-directed strength training program did not decrease overuse injury incidence resulting in marathon noncompletion. CLINICAL RELEVANCE: Prevention strategies such as strength training need to be developed and evaluated through clinical trials to reduce the high prevalence of overuse injuries in runners, especially for high-risk populations such as first-time marathon runners.


Assuntos
Transtornos Traumáticos Cumulativos/prevenção & controle , Extremidade Inferior/lesões , Força Muscular/fisiologia , Resistência Física/fisiologia , Treinamento de Resistência , Corrida/lesões , Adulto , Transtornos Traumáticos Cumulativos/epidemiologia , Transtornos Traumáticos Cumulativos/fisiopatologia , Humanos , Cidade de Nova Iorque/epidemiologia , Fatores de Risco , Corrida/fisiologia
2.
J Am Heart Assoc ; 8(14): e012235, 2019 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-31286819

RESUMO

Background Preparticipation cardiovascular screening in athletes is fully endorsed by major medical societies, yet the most effective screening protocol remains debated. We prospectively compared the performance of the American Heart Association ( AHA ) 14-point screening evaluation and a resting ECG for cardiovascular screening of high school athletes. Methods and Results Competitive athletes participating in organized high school or premier/select level sports underwent cardiovascular screening using the AHA 14-point history and physical examination, and an ECG interpreted with the Seattle Criteria. A limited echocardiogram was performed for all screening abnormalities. The primary outcome measure was identification of a cardiovascular disorder associated with sudden cardiac death. From October 2014 to June 2017, 3620 high school athletes (median age, 16 years; range 13-19; 46.2% female; 78.6% white, 8.0% black) were screened. One or more positive responses to the AHA 14-point questionnaire were present in 814 (22.5%) athletes. The most common history responses included chest pain (8.1%), family history of inheritable conditions (7.3%), and shortness of breath (6.4%). Abnormal physical examination was present in 356 (9.8%) athletes, and 103 (2.8%) athletes had an abnormal ECG . Sixteen (0.4%) athletes had conditions associated with sudden cardiac death. The sensitivity (18.8%), specificity (68.0%), and positive predictive value (0.3%) of the AHA 14-point evaluation was substantially lower than the sensitivity (87.5%), specificity (97.5%), and positive predictive value (13.6%) of ECG . Conclusions The AHA 14-point evaluation performs poorly compared with ECG for cardiovascular screening of high school athletes. The use of consensus-derived history questionnaires as the primary tool for cardiovascular screening in athletes should be reevaluated.

3.
Clin J Sport Med ; 2019 Jun 14.
Artigo em Inglês | MEDLINE | ID: mdl-31219928

RESUMO

OBJECTIVE: To generate a summative report on the most commonly diagnosed illnesses in Major League Baseball (MLB) and Minor League Baseball (MiLB) athletes with specific attention to their impact based on time out of play. DESIGN: Retrospective analysis. SETTING: Injury and illness data from the MLB Health and Injury Tracking System. PARTICIPANTS: All MLB and MiLB athletes active between 2011 and 2016. ASSESSMENT OF RISK FACTORS: Illnesses were defined as atraumatic medical diagnoses that occurred during the MLB or MiLB season and resulted in at least 1 day out of play. MAIN OUTCOME MEASURES: Incidence of illness diagnoses and resulting time out play. RESULTS: Eight thousand eight hundred thirty-four illnesses were reported, representing 14.7% of all diagnoses resulting in time out of play. Total days missed (DM) due to illness were 39 614, with a mean of 4.6 (SD 9.9 days) and median 2 DM per diagnosis. The annual incidence of illness per season was 20.3 per 100 athletes. The most common diagnosis was nonspecific viral illness (15.3%), followed by gastroenteritis (13.6%), other gastrointestinal illness (8.3%), influenza (7.0%), and upper respiratory infection (6.2%). Appendicitis (15.2%) and Epstein-Barr virus/cytomegalovirus (9.1%) were the most common season-ending diagnoses. CONCLUSIONS: Illnesses represent a significant cause of time out of play in MLB and MiLB. Prevention efforts should focus on limiting the spread of communicable viral, respiratory, and gastrointestinal disease among players, as the majority of diagnoses fell into these categories. This work may be used to guide future research into illness treatment and prevention in professional baseball.

4.
Br J Sports Med ; 53(17): 1085-1092, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31235615

RESUMO

OBJECTIVE: To describe the incidence of injuries and illnesses sustained during the XXIII Olympic Winter Games, hosted by PyeongChang on 9-25 February 2018. METHODS: We recorded the daily number of athlete injuries and illnesses (1) through the reporting of all National Olympic Committee (NOC) medical teams and (2) in the polyclinic and medical venues by the PyeongChang 2018 medical staff. RESULTS: In total, 2914 athletes (1210 women, 42%; 1704 men, 58%) from 92 NOCs were observed for occurrence of injury and illness. NOC and PyeongChang 2018 medical staff reported 376 injuries and 279 illnesses, equalling 12.6 injuries and 9.4 illnesses per 100 athletes over the 17-day period. Altogether, 12% of the athletes incurred at least one injury and 9% at least one illness. The injury incidence was highest in ski halfpipe (28%), snowboard cross (26%), ski cross (25%), snowboard slopestyle (21%) and aerials (20%), and lowest in Nordic combined, biathlon, snowboard slalom, moguls and cross-country skiing (2%-6%). Of the 376 injuries recorded, 33% and 13% were estimated to lead to ≥1 day and >7 days of absence from sport, respectively. The highest incidences of illness were recorded in biathlon (15%), curling (14%), bobsleigh (14%) and snowboard slalom (13%). Thirty per cent of the illnesses were expected to result in time loss, and 70% affected the respiratory system. Women suffered 61% more illnesses than men. CONCLUSION: Overall, 12% of the athletes incurred at least one injury during the Games and 9% an illness, incidences that are similar to the Olympic Winter Games of 2010 and 2014.


Assuntos
Traumatismos em Atletas/epidemiologia , Doença , Aniversários e Eventos Especiais , Atletas , Comportamento Competitivo , Feminino , Humanos , Incidência , Masculino , Estudos Prospectivos , República da Coreia , Estações do Ano
6.
Clin J Sport Med ; 2018 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-29952837

RESUMO

OBJECTIVE: To assess the available infrastructure for secondary testing after preparticipation cardiovascular screening of collegiate athletes. DESIGN: Cross-sectional study. SETTING: National Collegiate Athletic Association (NCAA) athletic programs PARTICIPANTS:: Team physicians. INTERVENTIONS: Online survey distributed by the NCAA and American Medical Society for Sports Medicine. MAIN OUTCOME MEASURES: Availability of secondary cardiovascular diagnostic testing and services. RESULTS: Team physicians from 235 schools completed the assessment, representing 21% of all NCAA schools. Ninety (38.3%) NCAA team physicians reported screening athletes using electrocardiogram (ECG). Division I schools were more likely than Division II and III schools to perform both screening ECG (RR, 2.38, P < 0.0001) and echocardiogram (RR, 2.83, P = 0.01). More than 97% of schools had access to resting echocardiogram, stress ECG/echocardiogram, and Holter monitoring within 25 miles with no significant variability between divisions, regions, or size of undergraduate student body. Cardiac magnetic resonance imaging and electrophysiology studies were available within 25 miles of more than 80% of schools, and genetics testing was available within 25 miles for 64.8%. CONCLUSIONS: Secondary testing for cardiovascular abnormalities seems to be readily available for NCAA athletes, regardless of division, region, or school size.

7.
Sports Health ; 10(5): 406-411, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29792776

RESUMO

BACKGROUND: Multiple outbreaks of vaccine-preventable viral diseases have occurred in professional sports in recent years. Currently, there is no established protocol for vaccination or immunity screening for professional athletes. HYPOTHESIS: There are significant differences in the prevalence of inadequate immunity dependent on age, sport, country of birth, and participation in collegiate sports. STUDY DESIGN: Cross-sectional cohort study. LEVEL OF EVIDENCE: Level 4. METHODS: A sample of Major League Baseball (MLB) and National Basketball Association (NBA) players were screened for serologic evidence of immunity to measles, mumps, rubella, and varicella prior to the 2015 and 2016 seasons. The results were designated as adequate (immune) or inadequate (equivocal or nonimmune) based on laboratory criteria. Comparison with an age-matched control group was performed using data from the National Health and Nutrition Examination Survey (NHANES). RESULTS: A total of 98 athletes (62 MLB, 36 NBA) were screened. The prevalence of inadequate immunity for any virus was 35.5% in MLB players and 33.3% in NBA players. There was a significantly greater risk of inadequate immunity to rubella (risk ratio, 6.38; P < 0.01) and varicella (risk ratio, 4.21; P < 0.01) in athletes compared with the age-matched NHANES population. Our analysis did not reveal differences in rates of immunity based on sport, country of birth (US born vs international), or participation in college athletics. There was a lower rate of inadequate immunity to varicella with increasing age (odds ratio, 0.72; P = 0.05). CONCLUSION: One-third of athletes studied had inadequate immunity to 1 of the 4 viruses tested. Younger players had a significantly greater risk of inadequate immunity to varicella. Birth outside the US and lack of participation in college athletics were not found to influence immunity rates. CLINICAL RELEVANCE: These results can inform the development of future screening programs to prevent outbreaks of viral infections in professional athletes.


Assuntos
Beisebol/fisiologia , Basquetebol/fisiologia , Varicela/imunologia , Imunidade Ativa , Sarampo/imunologia , Caxumba/imunologia , Rubéola (Sarampo Alemão)/imunologia , Adulto , Varicela/prevenção & controle , Estudos de Coortes , Estudos Transversais , Humanos , Masculino , Sarampo/prevenção & controle , Caxumba/prevenção & controle , Projetos Piloto , Prevalência , Rubéola (Sarampo Alemão)/prevenção & controle , Estados Unidos/epidemiologia , Vacinação/estatística & dados numéricos , Adulto Jovem
8.
Br J Sports Med ; 52(17): 1097-1100, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-29794086

RESUMO

OBJECTIVE: The IOC recommends periodic cardiovascular screening of athletes, but the adoption of these recommendations is unknown. The purpose of this investigation was to evaluate and compare cardiovascular screening practices of countries participating in the Rio 2016 Olympic Games. METHODS: A list of chief medical officers (CMOs) was compiled by the IOC during the 2016 Olympic Games. CMOs were requested to complete an online survey about cardiovascular screening of their countries' Olympic athletes. Comparisons of screening practices were made by categorising countries by continent, gross domestic product (GDP) per capita and size of athlete delegation. RESULTS: CMOs for 117/207 (56.5%) countries participating in the 2016 Olympic Games were identified. 94/117 countries (80.3%) completed the survey, representing 45.4% of all countries and 8805/11 358 (77.5%) of all 2016 Olympic athletes. Most of the countries surveyed (70.2%) perform annual cardiovascular screening. Among the survey respondents, all or most athletes from each country were screened at least once with the following components: personal history (86.2% of countries), family history (85.1%), physical examination (87.2%), resting ECG (74.5%), echocardiogram (31.9%) and stress test (30.8%). Athletes were more likely to be screened with ECG in countries with relatively larger athlete delegation (OR 2.05, 95% CI 1.10 to 3.80, p=0.023) and with higher GDP per capita (OR 1.69, 95% CI 1.11 to 2.57, p=0.014). CONCLUSION: Most of the responding countries perform annual cardiovascular screening of Olympic athletes, but there are differences in the components used. Athletes from countries with larger athlete delegations and higher GDP per capita were more likely to be screened with ECG.


Assuntos
Atletas , Sistema Cardiovascular , Doenças Cardiovasculares/diagnóstico , Ecocardiografia , Teste de Esforço , Humanos , Anamnese , Esportes , Medicina Esportiva , Inquéritos e Questionários
10.
Sports Health ; 8(5): 438-43, 2016 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-27436751

RESUMO

As public health experts work to contain the outbreak of Zika virus in South America and minimize the devastating prenatal complications, the international sports community prepares for the 2016 Summer Olympic and Paralympic Games in Rio de Janeiro, Brazil. Athletes have publicly expressed concern regarding the health risks of competition in Zika-endemic areas.(33) Ensuring the safety of the athletes during training and competition is the primary role of the team physician. Special consideration is needed for sports teams preparing for travel to areas affected by Zika virus.


Assuntos
Aniversários e Eventos Especiais , Surtos de Doenças , Esportes , Viagem , Infecção por Zika virus/epidemiologia , Brasil/epidemiologia , Diagnóstico Diferencial , Surtos de Doenças/prevenção & controle , Síndrome de Guillain-Barré/virologia , Humanos , Infecção por Zika virus/diagnóstico , Infecção por Zika virus/prevenção & controle , Infecção por Zika virus/transmissão
11.
Sports Health ; 7(5): 452-7, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26502423

RESUMO

BACKGROUND: The National Collegiate Athletic Association (NCAA) has recently highlighted mental health concerns in student athletes, though the incidence of suicide among NCAA athletes is unclear. The purpose of this study was to determine the rate of suicide among NCAA athletes. HYPOTHESIS: The incidence of suicide in NCAA athletes differs by sex, race, sport, and division. STUDY DESIGN: Retrospective cohort study. LEVEL OF EVIDENCE: Level 3. METHODS: NCAA Memorial Resolutions list and published NCAA demographic data were used to identify student-athlete deaths and total participant seasons from 2003-2004 through 2011-2012. Deaths were analyzed by age, sex, race, division, and sport. RESULTS: Over the 9-year study period, 35 cases of suicide were identified from a review of 477 student-athlete deaths during 3,773,309 individual participant seasons. The overall suicide rate was 0.93/100,000 per year. Suicide represented 7.3% (35/477) of all-cause mortality among NCAA student athletes. The annual incidence of suicide in male athletes was 1.35/100,000 and in female athletes was 0.37/100,000 (relative risk [RR], 3.7; P < 0.01). The incidence in African American athletes was 1.22/100,000 and in white athletes was 0.87/100,000 (RR, 1.4; P = 0.45). The highest rate of suicide occurred in men's football (2.25/100,000), and football athletes had a relative risk of 2.2 (P = 0.03) of committing suicide compared with other male, nonfootball athletes. CONCLUSION: The suicide rate in NCAA athletes appears to be lower than that of the general and collegiate population of similar age. NCAA male athletes have a significantly higher rate of suicide compared with female athletes, and football athletes appear to be at greatest risk. CLINICAL RELEVANCE: Suicide represents a preventable cause of death, and development of effective prevention programs is recommended.


Assuntos
Esportes/estatística & dados numéricos , Suicídio/estatística & dados numéricos , Grupo com Ancestrais do Continente Africano/estatística & dados numéricos , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Feminino , Humanos , Incidência , Masculino , Estudos Retrospectivos , Distribuição por Sexo , Suicídio/etnologia , Estados Unidos/epidemiologia , Adulto Jovem
12.
Curr Sports Med Rep ; 13(5): 307-13, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25211618

RESUMO

The physical examination of the shoulder has been studied extensively, but the quality and statistical power of the published research often is lacking. The initial reports of new shoulder examination techniques commonly describe impressive performance. However recent meta-analyses have found that when the majority of these tests are used in isolation, they lack the ability to rule in or rule out the pathology in question, with few exceptions. The diagnostic accuracy of the physical examination improves when the shoulder tests are evaluated in combination, such as positive passive distraction and active compression identifying a superior labral anterior to posterior (SLAP) lesion. The accuracy also can be improved when the shoulder tests are evaluated in conjunction with specific historical findings, such as age greater than 39 years, history of popping or clicking, and a positive painful arc (pain experienced between 60° and 120° of abduction) identifying rotator cuff tendinopathy. The literature on shoulder imaging demonstrates that rotator cuff tears can be ruled in or ruled out by both ultrasound and magnetic resonance imaging. For SLAP lesions, magnetic resonance arthrography can be used to rule out a tear but may not be as accurate as combined physical examinations to rule in a tear.


Assuntos
Exame Físico/métodos , Síndrome de Colisão do Ombro/diagnóstico , Lesões do Ombro , Articulação do Ombro/lesões , Tendinopatia/diagnóstico , Medicina Baseada em Evidências , Humanos , Imagem por Ressonância Magnética , Amplitude de Movimento Articular , Manguito Rotador/diagnóstico por imagem , Manguito Rotador/patologia , Lesões do Manguito Rotador , Ombro/diagnóstico por imagem , Ombro/patologia , Articulação do Ombro/diagnóstico por imagem , Articulação do Ombro/patologia , Ultrassonografia
13.
Br J Sports Med ; 48(15): 1172-8, 2014 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-24948082

RESUMO

BACKGROUND: This study compares the accuracy of cardiovascular screening in active adolescents and young adults using a standardised history, physical examination and resting 12-lead ECG. METHODS: Participants were prospectively screened using a standardised questionnaire based on the Pre-participation Physical Evaluation Monograph 4th Edition (PPE-4), physical examination and ECG interpreted using modern standards. Participants with abnormal findings had focused echocardiography and further evaluation. Primary outcomes included disorders associated with sudden cardiac arrest (SCA). RESULTS: From September 2010 to July 2011, 1339 participants underwent screening: age 13-24 (mean 16) years, 49% male, 68% Caucasian, 17% African-American and 1071 (80%) participating in organised sports. Abnormal history responses were reported on 916 (68%) questionnaires. After physician review, 495/916 (54%) participants with positive questionnaires were thought to have non-cardiac symptoms and/or a benign family history and did not warrant additional evaluation. Physical examination was abnormal in 124 (9.3%) participants, and 72 (5.4%) had ECG abnormalities. Echocardiograms were performed in 586 (44%) participants for abnormal history (31%), physical examination (8%) or ECG (5%). Five participants (0.4%) were identified with a disorder associated with SCA, all with ECG-detected Wolff-Parkinson-White. The false-positive rates for history, physical examination and ECG were 31.3%, 9.3% and 5%, respectively. CONCLUSIONS: A standardised history and physical examination using the PPE-4 yields a high false-positive rate in a young active population with limited sensitivity to identify those at risk for SCA. ECG screening has a low false-positive rate using modern interpretation standards and improves detection of primary electrical disease at risk of SCA.


Assuntos
Morte Súbita Cardíaca/prevenção & controle , Medicina Esportiva/métodos , Adolescente , Ecocardiografia/métodos , Eletrocardiografia/métodos , Feminino , Humanos , Masculino , Exame Físico/métodos , Prognóstico , Estudos Prospectivos , Síncope/diagnóstico , Síndrome de Wolff-Parkinson-White/diagnóstico , Adulto Jovem
14.
Heart Rhythm ; 11(7): 1190-4, 2014 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-24732370

RESUMO

BACKGROUND: An accurate estimate of the incidence of sudden cardiac arrest (SCA) in high school student athletes is needed to guide prevention strategies. OBJECTIVE: To prospectively investigate SCA rates in high school student athletes vs student nonathletes. METHODS: A prospective observational study of 2149 US high schools participating in the National Registry for AED Use in Sports was conducted from August 2009 to July 2011. Schools were contacted quarterly to collect and review SCA cases occurring on school campus. Ninety-five percent (2045) of the schools confirmed participation for the entire 2-year period. RESULTS: The average numbers of total students and student athletes per school were 963 and 367, respectively, providing more than 4.1 million total student-years and more than 1.5 million student athlete-years of surveillance. Twenty-six cases of SCA occurred in students, including 18 cases in student athletes-all during exercise. The incidence of SCA in all students was 0.63 per 100,000; in student athletes, 1.14 per 100,000; and in student nonathletes, 0.31 per 100,000. The relative risk of SCA in student athletes vs nonathletes was 3.65 (95% confidence interval 1.6-8.4; P < .01). Sixteen of 18 (89%) student athletes with SCA were boys, resulting in an incidence of 1.73 per 100,000 in boys and 0.31 per 100,000 in girls and a relative risk in male compared with female student athletes of 5.65 (95% confidence interval 1.3-24.6; P < .01). CONCLUSION: The incidence of SCA in high school student athletes is higher than previous estimates and may justify more advanced cardiac screening and improved emergency planning in schools.


Assuntos
Atletas/estatística & dados numéricos , Morte Súbita Cardíaca/epidemiologia , Adolescente , Feminino , Humanos , Incidência , Masculino , Estudos Prospectivos , Sistema de Registros , Medição de Risco , Instituições Acadêmicas , Estudantes
15.
Br J Sports Med ; 47(18): 1179-83, 2013 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-24124037

RESUMO

BACKGROUND: Sudden cardiac arrest (SCA) is the leading cause of death in athletes during exercise. The effectiveness of school-based automated external defibrillator (AED) programmes has not been established through a prospective study. METHODS: A total of 2149 high schools participated in a prospective observational study beginning 1 August 2009, through 31 July 2011. Schools were contacted quarterly and reported all cases of SCA. Of these 95% of schools confirmed their participation for the entire 2-year study period. Cases of SCA were reviewed to confirm the details of the resuscitation. The primary outcome was survival to hospital discharge. RESULTS: School-based AED programmes were present in 87% of participating schools and in all but one of the schools reporting a case of SCA. Fifty nine cases of SCA were confirmed during the study period including 26 (44%) cases in students and 33 (56%) in adults; 39 (66%) cases occurred at an athletic facility during training or competition; 55 (93%) cases were witnessed and 54 (92%) received prompt cardiopulmonary resuscitation. A defibrillator was applied in 50 (85%) cases and a shock delivered onsite in 39 (66%). Overall, 42 of 59 (71%) SCA victims survived to hospital discharge, including 22 of 26 (85%) students and 20 of 33 (61%) adults. Of 18 student-athletes 16 (89%) and 8 of 9 (89%) adults who arrested during physical activity survived to hospital discharge. CONCLUSIONS: High school AED programmes demonstrate a high survival rate for students and adults who suffer SCA on school campus. School-based AED programmes are strongly encouraged.


Assuntos
Desfibriladores/estatística & dados numéricos , Parada Cardíaca Extra-Hospitalar/terapia , Esportes/estatística & dados numéricos , Adolescente , Adulto , Idoso , Tratamento de Emergência/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Parada Cardíaca Extra-Hospitalar/epidemiologia , Parada Cardíaca Extra-Hospitalar/mortalidade , Estudos Prospectivos , Serviços de Saúde Escolar , Medicina Esportiva/instrumentação , Análise de Sobrevida , Resultado do Tratamento , Estados Unidos/epidemiologia , Adulto Jovem
16.
J Athl Train ; 48(2): 242-7, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23672389

RESUMO

CONTEXT: School-based automated external defibrillator (AED) programs have demonstrated a high survival rate for individuals suffering sudden cardiac arrest (SCA) in US high schools. OBJECTIVE: To examine the relationship between high schools having an AED on campus and other measures of emergency preparedness for SCA. DESIGN: Cross-sectional study. SETTING: United States high schools, December 2006 to September 2009. PATIENTS OR OTHER PARTICIPANTS: Principals, athletic directors, school nurses, and certified athletic trainers represented 3371 high schools. MAIN OUTCOME MEASURE(S): Comprehensive surveys on emergency planning for SCA submitted by high school representatives to the National Registry for AED Use in Sports from December 2006 to September 2009. Schools with and without AEDs were compared to assess other elements of emergency preparedness for SCA. RESULTS: A total of 2784 schools (82.6%) reported having 1 or more AEDs on campus, with an average of 2.8 AEDs per school; 587 schools (17.4%) had no AEDs. Schools with an enrollment of more than 500 students were more likely to have an AED (relative risk [RR] = 1.12, 95% confidence interval [CI] = 1.08, 1.16, P < .01). Suburban schools were more likely to have an AED than were rural (RR = 1.08, 95% CI = 1.04, 1.11, P < .01), urban (RR = 1.13, 95% CI = 1.04, 1.16, P < .01), or inner-city schools (RR = 1.10, 95% CI = 1.04, 1.23, P < .01). Schools with 1 or more AEDs were more likely to ensure access to early defibrillation (RR = 3.45, 95% CI = 2.97, 3.99, P < .01), establish an emergency action plan for SCA (RR = 1.83, 95% CI = 1.67, 2.00, P < .01), review the emergency action plan at least annually (RR = 1.99, 95% CI = 1.58, 2.50, P < .01), consult emergency medical services to develop the emergency action plan (RR = 1.18, 95% CI = 1.05, 1.32, P < .01), and establish a communication system to activate emergency responders (RR = 1.06, 95% CI = 1.01, 1.08, P < .01). CONCLUSIONS: High schools with AED programs were more likely to establish a comprehensive emergency response plan for SCA. Implementing school-based AED programs is a key step associated with emergency planning for young athletes with SCA.


Assuntos
Morte Súbita Cardíaca/prevenção & controle , Desfibriladores , Capacitação em Serviço , Serviços de Saúde Escolar/organização & administração , Adulto , Distribuição de Qui-Quadrado , Defesa Civil , Estudos Transversais , Feminino , Humanos , Masculino , Sistema de Registros , Inquéritos e Questionários , Estados Unidos
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