Death rates up for some when marathons take place

USA TODAY - With the Boston Marathon looming, a new study reveals some troubling information: More people die of heart attacks and cardiac arrest when they fall ill during marathons.

The study suggests that a 15% jump in mortality is likely due to the extra time it takes to get sick patients to the hospital, said Anupam Jena, the Harvard Medical School associate professor who led the research.

Published Wednesday in the New England Journal of Medicine, the study found that among Medicare patients, the 30-day death rate from heart attacks and cardiac arrest jumped 15% for people who fall ill on marathon days in 11 U.S. cities. The 121st Boston Marathon will be run Monday.

Doctors and ambulances weren’t distracted by the race or overwhelmed treating runners, the study found. Instead, the traffic jams and route disruptions caused by marathons meant it took longer to bring patients to the hospital.

Ambulance rides lasted 4 minutes longer — 18 minutes instead of 14 — and private cars likely sat in traffic even longer, said Jena, who began the research after he missed watching his wife run a road race because he was trapped in Boston traffic.

The study was well-crafted, rigorously analyzed and showed an imaginative use of data, said Donald A. Redelmeier, a professor of medicine at the University of Toronto in Canada. But its limitations mean that other factors could also have been at play in driving up the mortality rate, said Redelmeier, who also studies the health implications of major public events.

It’s possible, he said, that more Medicare patients had heart attacks on marathon days because their home caregivers couldn’t make it in to help them because of subtle changes in staffing or priorities at hospitals or because only the sickest people sought care while such a major event was underway.

The road closures could save some lives as well — perhaps by preventing car crashes, Redelmeier said.

For its part, the city of Boston said it plans to keep ambulance service consistent regardless of major events such as the marathon, Fourth of July celebrations, political marches and sports championship parades.

“Boston EMS increases the number of ambulances assigned to support citywide coverage on the day of the race, with specific attention given to ensuring units are posted on both sides of the race course and around the city,” Jim Hooley, chief of Boston EMS, said in a written statement.

Jena said the clear implication of his research is that people should rely on ambulances — not themselves or their family members — to get them to the hospital on days such as the Boston Marathon when roads are closed and traffic is unusually high.

“The best chance of a good outcome is to get to the hospital quickly,” he said.



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