Marathons May Impact Mortality for Patients with Acute Medical Conditions Living near the Route

Summary and Comment |
April 12, 2017

Marathons May Impact Mortality for Patients with Acute Medical Conditions Living near the Route

  1. Ali S. Raja, MD, MBA, MPH

Older patients with myocardial infarction or cardiac arrest transported to hospitals near marathon routes had higher 30-day mortality when admitted on marathon days than on other days.

  1. Ali S. Raja, MD, MBA, MPH

Several studies have examined the medical effects of marathons on runners, yet little is known about the potential impact of marathon road closures, crowds, and other public service disruptions on emergency medical care for nonparticipants.

These researchers examined the impact of the 11 largest U.S. marathons on mortality in patients hospitalized for myocardial infarction or cardiac arrest. Using Medicare data from 2002 to 2012, the researchers compared 30-day mortality for patients transported to hospitals in zip codes along marathon routes on marathon days versus nonmarathon days (same day of the week, 5 weeks before and after the marathon), and for patients transported to hospitals in surrounding zip codes. The researchers also compared ambulance transport times and controlled for many potential confounders.

A total of 12,219 patients admitted to hospitals in marathon zip codes were included in the primary analysis. Adjusted 30-day mortality was significantly higher for patients admitted on marathon days than on nonmarathon days (28.6% vs. 24.9%). In addition, mean ambulance transport time was 4.4 minutes longer on marathon mornings than on nonmarathon days (18.1 vs. 13.7 minutes). Mortality at hospitals in surrounding zip codes did not differ for patients admitted on marathon and nonmarathon days.

Comment

Emergency departments typically prepare to treat runners and members of the crowd on marathon days, but these results remind us that other patients are affected by the transportation challenges caused by these large events. While the 4.4-minute increase in ambulance transport times likely did not have a significant clinical impact, imagine the even greater increase in transport times for patients presenting by private vehicles (as 23% of the patients in this study did). Hospital and event planners should take these findings into account when developing citywide preparedness plans for marathons and other large events.

Editor Disclosures at Time of Publication

  • Disclosures for Ali S. Raja, MD, MBA, MPH at time of publication Speaker's bureau Airway Management Education Center Leadership positions in professional societies Society for Academic Emergency Medicine (Board Member); American College of Emergency Physicians (Chair, Trauma and Injury Prevention Section)

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