Background Organised sports include individual water sports and athletic activities, team ball sports, team bat/stick sports and racquet sports. The causes of death, contributing factors and potential to prevent deaths in organised sports are poorly understood.

Objective To understand the causes of death and contributing factors in organised sports in Australia.

Design A case-series analysis was undertaken using the National Coronial Information System (NCIS) in Australia.

Setting Organised sports, including recreational and professional participants.

Patients Cases are ‘closed’ NCIS fatal cases aged 15 to 74 years who died in the period 2000 to 2016 as a result of participating in an organised sport.

Interventions No interventions were assessed.

Main Outcome Measurements These include the cause of death, mechanism of injury, contributing factors, demographic data, and sport participation.

Results There were 913 deaths in organised sports, with 89% being male. The largest group was 45–54 year olds (23%) and the smallest was 65 to 74 year olds (15%). The three sports groups accounting for the highest proportion of deaths were team ball sports (23%), wheeled motor sports (12%) and individual water sports (11%). Within team ball sports there were 98 deaths in organised football (Australian Rules, Rugby Union and Rugby League). Overall, the cause of death was cardiac, e.g. congestive cardiac failure and acute coronary syndrome, in 56% of cases, blunt force trauma in 29% and drowning in 7%. Cardiac deaths increased with age while blunt force trauma deaths reduced with age.

Conclusions There are age related differences in sport participation at time of death and cause of death that need consideration in planning for life long active participation in organised sport. Organised sports are governed by organisations with responsibility for setting player safety standards – informing these organisations of risks is critical for injury prevention, medical emergency policy and planning.