TY  - JOUR
PY  - 2018//
TI  - A systematic review of etiological risk factors associated with early mortality among National Football League players
JO  - Orthopaedic journal of sports medicine
A1  - Owora, Arthur H.
A1  - Kmush, Brittany L.
A1  - Walia, Bhavneet
A1  - Sanders, Shane
SP  - e2325967118813312
EP  - e2325967118813312
VL  - 6
IS  - 12
N2  - BACKGROUND: Multiple risks predispose professional football players to adverse health outcomes and, in extreme cases, early death; however, our understanding of etiological risk factors related to early mortality is limited. <br><br>PURPOSE: To identify etiological risk factors associated with all-cause and cause-specific mortality among National Football League (NFL) players. STUDY DESIGN: Systematic review; Level of evidence, 3. <br><br>METHODS: Articles examining all-cause and cause-specific mortality risk factors among previous NFL players were identified by systematically searching: PubMed, PsycINFO, Web of Science, and Google Scholar from 1990 to 2017. Study eligibility and quality were evaluated using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. <br><br>RESULTS: A total of 801 nonduplicated studies were identified through our search strategy. Of these, 9 studies examining 11 different risk factors were included in the systematic review. Overall, the risk of all-cause and cause-specific mortality was lower among NFL players than among the general male population in the United States. Nonwhite athletes, those in power positions, and those with a high playing-time body mass index (≥30 kg/m<sup>2</sup>) were associated with elevated all-cause and cardiovascular mortality risks. <br><br>CONCLUSION: Methodological issues associated with the examined all-cause and cause-specific mortality risk factors preclude a definitive conclusion of etiological protective or risk effects. Comparison groups less prone to selection bias ("healthy worker effect") and a life-course approach to the evaluation of suspected risk factors are warranted to identify etiological factors associated with early mortality among NFL players.<p />  <p>Language: en</p>
LA  - en
SN  - 2325-9671
UR  - http://dx.doi.org/10.1177/2325967118813312
ID  - ref1
ER  -