Triathlon is a competitive sporting event that began in the 1970s. It combines swimming, bicycling, and running and has become popular among adult recreational athletes. Some people have questioned the safety of triathlons, especially as they grow in popularity and attract increasing numbers of recreational athletes who may have underlying, undiagnosed medical conditions or may not train adequately for the swimming part of the event.

To describe death and cardiac arrest among triathlon participants.

Participants in U.S. triathlons from 1985 to 2016.

The researchers gathered information on deaths and cardiac arrests in U.S. triathlon participants from 1985 to 2016 from various sources, including the U.S. National Registry of Sudden Death in Athletes and USA Triathlon (USAT) records. From these sources, they collected data on the characteristics of participants who died or had a cardiac arrest, the timing of the death or cardiac arrest during the race, and such factors as the air and water temperature during the race. To help estimate the proportion of participants who died or had a cardiac arrest, the researchers collected information about the number of participants who completed triathlons from USAT records of participants who completed races from 2006 to 2016. This information was not available for earlier years.

A total of 107 sudden deaths, 13 cardiac arrests that responded to resuscitation, and 15 trauma-related deaths occurred in triathlon participants from 1985 to 2016. Of the participants who died, 85% were men and their average age was 47 years. Most sudden deaths and cardiac arrests occurred during the swimming event (90), but also happened during bicycling (7) and running (15). All trauma-related deaths occurred during bicycling. Using the data from 2006 to 2016, the researchers estimated that death or cardiac arrest occurs in about 1.74 of 100000 triathlon participants (2.4 per 100000 men and 0.74 per 100000 women). The risk was 18.6 per 100000 in men older than 60 years. The risk for death or cardiac arrest was similar in long, intermediate, and short triathlons. Autopsy information was available for 61 of the triathletes who died, 27 of whom had evidence of heart system abnormalities.

Identification of deaths and cardiac arrests may be incomplete in the registry data used for this study, so the researchers may have underestimated the number of events. Also, medical history and autopsy information were not available for most of the included deaths.

Sudden death, cardiac arrest, and trauma-related death occur during triathlons but are infrequent. Most of the deaths occurred in middle-aged and older men during the swimming part of the race.

铁人三项是一项始于1970年代的竞技体育赛事。它结合了游泳，骑自行车和跑步的功能，并在成年休闲运动员中广受欢迎。有些人质疑铁人三项的安全性，特别是随着三项铁人三项运动的普及和吸引越来越多的休闲运动员的参加，他们可能具有潜在的，未被诊断的医疗状况或可能没有为比赛的游泳部分进行充分的训练。

描述铁人三项参与者的死亡和心脏骤停。

1985年至2016年参加美国铁人三项比赛。

研究人员通过各种渠道收集了1985年至2016年美国铁人三项参与者死亡和心脏骤停的信息，包括美国国家运动员猝死登记表和美国铁人三项（USAT）记录。他们从这些来源收集有关死者或心脏骤停参与者的特征，比赛中死亡或心脏骤停的时间以及比赛中空气和水温等因素的数据。为了帮助估计死亡或患有心脏骤停的参与者的比例，研究人员从USAT记录了2006年至2016年比赛的参与者中收集了有关完成铁人三项的参与者数量的信息。

从1985年到2016年，铁人三项参与者共发生107例猝死，13例因复苏引起的心脏骤停以及15例与创伤有关的死亡。在死亡的参与者中，男性占85％，平均年龄为47岁。大多数猝死和心脏骤停发生在游泳比赛中（90），但也发生在骑自行车（7）和跑步期间（15）。所有与创伤有关的死亡都发生在骑车过程中。利用2006年至2016年的数据，研究人员估计，每十万名铁人三项参加者中约有1.74发生了死亡或心脏骤停（每十万名男性中有2.4人，每十万女性中有0.74人）。年龄在60岁以上的男性中，这一风险为每10万名男性中有18.6％。长，中，短铁人三项运动员的死亡或心脏骤停风险相似。死者的铁人三项运动员的尸检信息可用61名，其中27名有心脏系统异常的证据。

死亡和心脏骤停的识别在本研究使用的注册表数据中可能并不完整，因此研究人员可能低估了事件的数量。此外，大多数死亡病例均无病史和尸检信息。

铁人三项期间会发生猝死，心脏骤停和与创伤有关的死亡，但这种情况很少发生。大多数死亡发生在比赛游泳阶段的中老年人。