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The Lausanne recommendations: a Dutch experience
B Bessem1, F P Groot, W Nieuwland
1University Medical Centre Groningen, Department of Sports Medicine, Groningen, The Netherlands. b.bessem@sport.umcg.nl
Insights
Preparticipation cardiovascular screening using Lausanne recommendations in the Netherlands identified a low rate of athletes needing further testing. The number needed to screen for potentially lethal cardiovascular disease was 143, indicating an acceptable range.
Area of Science:
- Sports Medicine
- Cardiology
- Preventive Medicine
Background:
- Preparticipation cardiovascular screening is crucial for identifying athletes at risk of sudden cardiac death.
- The Lausanne recommendations provide a standardized approach to cardiovascular screening in athletes.
- Implementing established screening protocols is essential for consistent and reliable results.
Purpose of the Study:
- To evaluate the outcomes of cardiovascular screening in athletes using the Lausanne recommendations over 28 months.
- To assess the effectiveness of the screening protocol in identifying athletes with potentially lethal cardiovascular diseases.
- To determine the number of athletes needing screening to detect one case of serious cardiovascular conditions.
Main Methods:
- Data collected from 825 cardiovascular screenings performed between January 2006 and April 2008.
- Exclusion criteria included age extremes, multiple screenings, and pre-existing cardiovascular disease.
- Screening involved personal/family history, physical examination, and electrocardiogram (ECG).
Main Results:
- 87% of athletes had negative screening results.
- 13% required additional testing, with 6.3% referred based on ECG abnormalities alone.
- A positive screening result led to sports restriction for 0.7% of athletes; the number needed to screen was 143.
Conclusions:
- The Lausanne recommendations, when applied in the Netherlands, yield screening results comparable to international studies.
- The number needed to screen to identify an athlete with a potentially lethal cardiovascular disease is within an acceptable range.
- This study supports the utility of the Lausanne recommendations for preparticipation cardiovascular screening in athletic populations.
Objective:
This study presents the results of 28 months of preparticipation cardiovascular screening using the Lausanne recommendations, which include a personal and family history, physical examination and electrocardiogram (ECG).
Design:
From January 2006 to April 2008 the data of the Lausanne screenings carried out at the University Centre of Sports Medicine in Groningen were collected.
Participants:
825 cardiovascular screenings were performed of which 397 were excluded. Exclusion criteria were age under 12 or over 35 years, multiple screenings (only the first was included) and known cardiovascular disease.
Main Outcome Measures:
Negative screening result, (false) positive screening result, medical consumption and number needed to screen.
Results:
A total of 371 (87%) athletes had a negative screening result. Fifty-five athletes (13%) underwent additional (stage 2) testing and seven (1.6%) further (stage 3) testing. Only 27 athletes (6.3%) were referred for additional testing based only on abnormalities of their ECG. Forty-seven athletes (11%) had a false-positive screening result. Ten athletes (2%) had a positive screening result and three (0.7%) were ultimately restricted from sports participation. Stage 2 medical consumption was 62%, 20% and 18% for one, two and three or more additional tests, respectively. Stage 3 medical consumption was 1.6%. The number of athletes needed to screen to find a single athlete with a potentially lethal cardiovascular disease was 143.
Conclusion:
This study found that when the Lausanne recommendations are implemented in The Netherlands, screening results resemble those found in previous studies. The number of athletes needed to screen to detect one athlete with a potentially lethal cardiovascular disease is also within an acceptable range.
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