Retrospective Study for the Safer Management for Citizens' Marathon: A Medical Support Perspective

Area of Science:

• Epidemiology
• Sports Medicine
• Public Health

Background:

• Rising participation in marathons necessitates advanced medical support systems to mitigate health risks, including cardiac arrest.
• Effective event safety relies on early risk prediction, rapid medical intervention, and optimized emergency transport logistics.

Purpose of the Study:

• To analyze medical incidents at the Yokohama Citizen's Marathon from 2015 to 2024, focusing on the full marathon.
• To evaluate trends in the event's medical support system and their impact on participant outcomes.

Main Methods:

• Retrospective epidemiological study analyzing medical records of 147,861 runners over a 10-year period (2015-2024).
• Focused on incidence of cardiac arrest, heat stroke, muscle cramps, and other conditions, alongside medical support system evolution.

Main Results:

• 136 emergency transports (0.1% of runners) and 27 hospitalizations (0.02% of runners) were recorded, with 3 cardiac arrests (0.002% of runners).
• Patient Presentation Ratio (PPR) averaged 14.76 per 1000 runners; Transport-to-Hospital Ratio (TTHR) was 0.96 per 100 presentations.
• Annual protocol updates correlated with reduced PPR and stable TTHR, indicating improved medical support effectiveness.

Conclusions:

• Continuous evaluation and adaptation of medical data and protocols are essential for enhancing safety in large-scale marathon events.
• Systematic improvements in medical support planning and response are linked to reduced emergency incidents.
• While minor incidents are common, life-threatening events highlight the need for meticulous planning, interdisciplinary collaboration, and communication.