Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, South Africa; International Olympic Committee (IOC) Research Centre, South Africa.
Comrades Marathon, South Africa.
J Sci Med Sport. 2024 Nov;27(11):753-758. doi: 10.1016/j.jsams.2024.07.008. Epub 2024 Jul 16.
To identify the risk factors associated with all medical encounters (MEs) and serious/life-threatening MEs (SLMEs) during the Comrades Marathon.
Prospective cohort study, with cross-sectional analyses.
During the 2014-2019 Comrades Marathon, all MEs (including SLMEs) were recorded in 103,131 starters. For both all MEs and SLMEs, the following risk factors were explored: sex, age, route ("up" vs. "down" race), previous Comrades experience (yes/no), wet-blub globe temperature (WBGT) and race pace. Incidence (per 1000 starters; 95%CI), and the incidence ratio (IR; 95%CI) are presented.
For all MEs, being female was a significant risk factor (females vs. males IR = 1.47, p < 0.0001), and age was only marginally significant (p = 0.0167). Therefore factors for all MEs were adjusted for sex. Other factors significantly associated with all MEs were: higher WBGT (highest WBGT compared to lowest, IR = 1.33, p = 0.0003), race pace (highest risk for those who finish either among the first quarter [IR = 1.49] or last quarter [IR = 1.46] compared to middle pace; p < 0.0001) and the route ("down" vs. "up": IR = 1.11; p = 0.0181). Factors associated with higher risk for SLMEs were: females (IR = 1.9; p = 0.0003), "down" vs. "up" route (IR = 1.37; p = 0.0306) and race pace (slower and faster runners vs. mid (6.4-7.1 min/km) race pace category (IR > 2.1, p < 0.0001)).
Intrinsic (female, faster and slower race pace) and extrinsic (higher WBGT and the "down" route) are novel risk factors associated with all MEs at this event. These can be considered by the race organizers and the medical team to develop and implement prevention strategies.
确定与 Comrades 马拉松赛期间所有医疗接触（MEs）和严重/危及生命的 MEs（SLMEs）相关的风险因素。
前瞻性队列研究，进行横断面分析。
在 2014 年至 2019 年期间的 Comrades 马拉松赛中，所有 MEs（包括 SLMEs）都在 103131 名起跑者中进行了记录。对于所有 MEs 和 SLMEs，均探讨了以下风险因素：性别、年龄、路线（“上”径 vs. “下”径）、之前的 Comrades 参赛经验（是/否）、湿球黑球温度（WBGT）和比赛速度。以每 1000 名起跑者为单位报告发生率（95%CI）和发病率比（IR；95%CI）。
对于所有 MEs，女性是一个显著的风险因素（女性 vs. 男性 IR=1.47，p<0.0001），而年龄则只是略有意义（p=0.0167）。因此，所有 MEs 的因素均调整为性别。与所有 MEs 显著相关的其他因素是：较高的 WBGT（与最低 WBGT 相比，最高 WBGT，IR=1.33，p=0.0003）、比赛速度（与中间速度相比，最快完成前四分之一[IR=1.49]或最后四分之一[IR=1.46]的人风险最高；p<0.0001）和路线（“下”径 vs. “上”径：IR=1.11；p=0.0181）。与 SLMEs 风险较高相关的因素是：女性（IR=1.9；p=0.0003）、“下”径 vs. “上”径（IR=1.37；p=0.0306）和比赛速度（较慢和较快的跑步者与中间（6.4-7.1 min/km）比赛速度类别（IR>2.1，p<0.0001））。
内在因素（女性、较快和较慢的比赛速度）和外在因素（较高的 WBGT 和“下”径）是与该赛事所有 MEs 相关的新风险因素。这些因素可以被赛事组织者和医疗队考虑，以制定和实施预防策略。
