{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T12:15:13Z","timestamp":1792757713602,"version":"4.5.0"},"reference-count":30,"publisher":"BMJ","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br J Sports Med"],"accepted":{"date-parts":[[2012,2,10]]},"published-print":{"date-parts":[[2012,4]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>This study examines sickle cell trait (SCT) as a cause of sudden death in National Collegiate Athletic Association (NCAA) athletes and explores the cost-effectiveness of different screening models.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>The authors reviewed the cause of all cases of sudden death in NCAA student-athletes from January 2004 through December 2008. The authors also explored the cost-effectiveness of screening for this condition in selected populations assuming that identifying athletes with SCT would prevent death.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>There were 273 deaths and a total of 1 969 663 athlete-participant-years. Five (2%) deaths were associated with SCT. In football athletes, there were 72 (26%) deaths. Of these, 52 (72%) were due to trauma unrelated to sports activity and 20 (28%) were due to medical causes; nine deaths were cardiac (45%), five were associated with SCT (25%). Thirteen of the 20 deaths due to medical causes occurred during exertion; cardiac (6, 46%) SCT associated (5, 39%), and heat stroke unrelated to SCT (2, 15%). All deaths associated with SCT occurred in black Division I football athletes. The risk of exertional death in Division I football players with SCT was 1:827 which was 37 times higher than in athletes without SCT. The cost per case identified varied widely depending on the population screened and the price of the screening test.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Exertional death in athletes with SCT occurs at a higher rate than previously appreciated. More research is needed to (1) understand the pathophysiology of death in SCT-positive athletes and (2) determine whether screening high-risk populations reduces mortality.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bjsports-2011-090896","type":"journal-article","created":{"date-parts":[[2012,3,23]],"date-time":"2012-03-23T07:45:32Z","timestamp":1332488732000},"page":"325-330","source":"Crossref","is-referenced-by-count":122,"title":["Sickle cell trait associated with a RR of death of 37 times in national collegiate athletic association football athletes: a database with 2 million athlete-years as the denominator"],"prefix":"10.1136","volume":"46","author":[{"given":"Kimberly G","family":"Harmon","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan A","family":"Drezner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Klossner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irfan M","family":"Asif","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2012,3,22]]},"reference":[{"key":"2025080114100363000_46.5.325.1","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1249\/JSR.0b013e3181fc73d7","article-title":"Sickle cell trait in sports","volume":"9","author":"Eichner","year":"2010","journal-title":"Curr Sports Med Rep"},{"key":"2025080114100363000_46.5.325.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.csm.2011.03.004"},{"key":"2025080114100363000_46.5.325.3","first-page":"300","article-title":"Sickle cell trait and sudden death\u2013bringing it home","volume":"99","author":"Mitchell","year":"2007","journal-title":"J Natl Med Assoc"},{"key":"2025080114100363000_46.5.325.4","doi-asserted-by":"publisher","DOI":"10.1097\/PAF.0b013e318187dfcd"},{"key":"2025080114100363000_46.5.325.5","unstructured":"Ashley-Koch A Yang Q Olney R . 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