{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T12:27:27Z","timestamp":1769689647847,"version":"3.49.0"},"reference-count":33,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2020,4,3]],"date-time":"2020-04-03T00:00:00Z","timestamp":1585872000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"IOC Research Center (South Africa) (partial funding), Medical Research Council"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Scandinavian Med Sci Sports"],"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Pre\u2010race screening and risk stratification in recreational endurance runners may predict adverse events (AEs) during a race.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To determine if pre\u2010race screening and risk stratification predict AEs during a race.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 29\u00a0585 participants (Male 71.1%, average age\u00a0=\u00a042.1\u00a0years; Female 28.9%, average age\u00a0=\u00a040.2\u00a0years) at the Two Oceans ultra\u2010marathon races (56\u00a0km) completed a pre\u2010race medical screening questionnaire and were risk stratified into four pre\u2010specified groups [very high risk (VHR; existing cardiovascular disease\u2013CVD: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\u2010not\u2010start (DNS) rate (per 1000 entrants that did\u2010not\u2010start), did\u2010not\u2010finish (DNF) rate (per 1000 starters that did\u2010not\u2010finish), 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Adverse events were significantly higher (per 1000 starters; 95%CI) in the VHR (68.9; 52.4\u201089.9:<jats:italic>P<\/jats:italic>\u00a0=\u00a0.0407) compared with the LR (51.3; 46.5\u201056.7). The DNS rate was significantly different between the IR (190.3; 184.0\u2010196.9) and LR (207.4; 199.2\u2010216.0: <jats:italic>P<\/jats:italic>\u00a0=\u00a0.0011). DNF rates were not different in the VHR (56.4; 41.9\u201075.9) compared to LR (44.2; 39.7\u201049.1: <jats:italic>P<\/jats:italic>\u00a0=\u00a0.1295), and ME rate was also not different between risk categories, however, VHR (12.9; 7.0\u201023.9) was approaching significance compared to LR (6.9; 5.2\u20109.1: <jats:italic>P<\/jats:italic>\u00a0=\u00a0.0662).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Pre\u2010race 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\u2010race medical screening in reducing AEs in endurance runners.<\/jats:p><\/jats:sec>","DOI":"10.1111\/sms.13659","type":"journal-article","created":{"date-parts":[[2020,3,18]],"date-time":"2020-03-18T20:45:55Z","timestamp":1584564355000},"page":"1205-1211","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Pre\u2010race screening and stratification predicts adverse events\u2014A 4\u2010year study in 29585 ultra\u2010marathon entrants, SAFER X"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1022-4780","authenticated-orcid":false,"given":"Nicola","family":"Sewry","sequence":"first","affiliation":[{"name":"Sport, Exercise Medicine and Lifestyle Institute (SEMLI) Faculty of Health Sciences University of Pretoria Pretoria South Africa"},{"name":"International Olympic Committee (IOC) Research Centre 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Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sonja","family":"Swanevelder","sequence":"additional","affiliation":[{"name":"Biostatistics Unit South African Medical Research Council Cape Town South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Esme","family":"Jordaan","sequence":"additional","affiliation":[{"name":"Biostatistics Unit South African Medical Research Council Cape Town South Africa"},{"name":"Statistics and Population Studies Department University of the Western Cape Cape Town South 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