Epidemiology Of Intra-event Medical Encounters For Gastrointestinal Complaints In Boston Marathon Participants

PURPOSE: To characterize the epidemiology of intra-event medical encounters (ME) for gastrointestinal complaints among Boston Marathon participants. METHODS: Institutional Review Board (IRB-P00043223) and event medical program approval was obtained. Retrospective review of paper medical records from the 2016, 2017, and 2021 Boston Marathons was performed to extract the following data: patient demographics, marathon experience, primary presenting complaint, treatment, duration of ME, and disposition. Data were transferred into a secure database (REDCap) and descriptive analyses were completed in Excel and SPSS. Parametric tests were used for normally distributed data, while non-parametric tests were used for non-normally distributed data. RESULTS: An aggregated total of 3,458 ME records were extracted, and of those, 922 (26.7%) had gastrointestinal complaints, defined as either nausea/vomiting and/or abdominal cramping as the chief presenting symptom. Of these 922 MEs, 462 (50%) were for women (W) and 460 (50%) were for men (M). Gastrointestinal complaints made up 24.5% of MEs among W and 29.2% of MEs among M. Among W presenting for gastrointestinal complaints, mean age was (±SD) 38.9 (±10.7) years, they had run (median, IQR) 4 (2, 8) prior marathons, and their mean ME duration was 48 ± 2 minutes, during which 71 (15.4%) received intravenous (IV) fluids; 17 (3.7%) did not finish (DNF), and 13 (2.8%) were transported to a hospital via ambulance. Among M presenting for gastrointestinal complaints, mean age was 42.5 (±12.5) years, they had run (median, IQR) 5 (2, 11) prior marathons, and mean ME duration was 46 ± 2 minutes, during which 93 (20.1%) received IV fluids; 15 (3.2%) DNF, and 15 (3.2%) were transported to a hospital via ambulance. CONCLUSION: Gastrointestinal complaints were prevalent among marathon runners, associated with substantial time in event medical stations, DNF outcomes, and need for hospital transport. Future efforts to mitigate gastrointestinal complaints among marathon athletes are warranted to reduce intra-event athlete morbidity. Supported by: Eleanor and Miles Shore Faculty Development Awards Program, Harvard Medical School, Boston Children's Hospital Department of Orthopaedic Surgery and Sports Medicine Award