Abstract 3092: Risk Associated with Sports Competition: Is Lacrosse Really a Uniquely Dangerous Sport?

Abstract

Background. Sudden deaths in young competitive athletes are tragic events having great personal impact on physicians and lay communities. These deaths occur in a wide variety of sports due largely to unsuspected cardiovascular disease or commotio cordis. Lacrosse is now the most rapidly growing sport in the U.S., presently with 500,000 competitors. The risks specifically associated with participation in lacrosse have been the subject of substantial media attention, implying that this sport may be unsafe relative to other youth sports. However, systematically assembled data in this regard are not available. Methods. The U.S. Sudden Death in Young Athletes Registry, 1980 –2008, was accessed and 22 sudden deaths (including 4 survivors of cardiac arrest) were identified in high school and college competitive lacrosse participants. Results. Ages were 13–22 years (mean 17±2y); all were male. Nineteen athletes died on the athletic field and 3 during sedentary activities. Ten of the 22 athletes died of non-penetrating blunt blows to the chest (i.e., commotio cordis), including 4 goalies who were wearing standard chest protectors. Another 10 athletes collapsed suddenly due to either documented or presumed cardiovascular disease (e.g., most commonly hypertrophic cardiomyopathy, long QT syndrome, mitral valve prolapse), and 2 incurred subarachnoid hemorrhage from blows to the head. The overall mortality rate associated with lacrosse was 1.39 deaths/100,000 person-years, and lower than a variety of other sports including baseball, basketball, and football (p=0.07), as well as hockey (p=0.1). Deaths due to commotio cordis were more frequent in lacrosse (0.63 deaths/100,000 person years) than in all other competitive sports (p<0.0001) with the exception of hockey (p=0.7). Conclusions. Sudden deaths in young high school and college lacrosse participants are rare relative to the number of athletes involved, and are caused disproportionately by commotio cordis. These findings underscore the importance of (and represent an impetus to) developing more effective chest protection for young people in this popular and growing competitive sport.