Center for Sports Medicine and Exercise Prescription, Treviso, Italy.
Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy
Br J Sports Med. 2020 Feb;54(4):231-237. doi: 10.1136/bjsports-2018-100293. Epub 2019 Jul 17.
Italian law mandates that every competitive athlete must undergo annual preparticipation evaluation (PPE) to identify cardiovascular (CV) diseases that pose a risk of sudden death (SD) during sport and other conditions that may threaten the athlete's health. We investigated the diagnostic yield, rate of disqualification and costs of our PPE.
We included 5910 consecutive apparently healthy athletes (61% males, mean age 15±4 years) who underwent annual PPE performed by a sports medicine specialist. The PPE included history, physical examination, weight, height and blood pressure measurement, test of visual acuity, spirometry, urine chemistry, resting 12-lead ECG and exercise testing with ECG monitoring. In cases of abnormal findings, we carried out second-line investigations.
During a 12-month study period, 5.326 (90.2%) athletes were cleared for competition after a normal first-line evaluation and 584 (9.8%) underwent one or more further examinations. Of those, 88 (1.5%) were diagnosed to have a CV disease (including 18 (0.3%) at-risk of SD) and 31 (0.5%) had a non-CV diagnosis. A total of 32 (0.5%) athletes were temporarily (n=15) or permanently (n=17) disqualified from competitive sports. The average cost per athlete was €79, which consisted of €64 (80%) for first-line evaluations and €15 (20%) for additional investigations.
PPE according to the Italian model identified a range of diseases in 2.0% of apparently healthy athletes at an average cost of €79.
意大利法律规定，每个竞技运动员都必须进行年度参赛前评估（PPE），以确定运动中导致猝死（SD）的心血管（CV）疾病和其他可能威胁运动员健康的疾病。我们研究了我们的 PPE 的诊断效果、淘汰率和成本。
我们纳入了 5910 名连续的看似健康的运动员（61%为男性，平均年龄 15±4 岁），他们由运动医学专家进行年度 PPE。PPE 包括病史、体格检查、体重、身高和血压测量、视力检查、肺功能检查、尿液化学检查、静息 12 导联心电图和运动试验伴心电图监测。如果发现异常，我们进行二线检查。
在 12 个月的研究期间，5326 名（90.2%）运动员在正常的一线评估后被清除参赛资格，584 名（9.8%）进行了一次或多次进一步检查。其中，88 名（1.5%）被诊断患有 CV 疾病（包括 18 名（0.3%）有 SD 风险），31 名（0.5%）患有非 CV 疾病。共有 32 名（0.5%）运动员暂时（n=15）或永久（n=17）被取消竞技体育资格。每名运动员的平均费用为 79 欧元，其中 64 欧元（80%）用于一线评估，15 欧元（20%）用于额外检查。
根据意大利模式的 PPE 在看似健康的运动员中发现了一系列疾病，平均费用为 79 欧元。
