Marathons Raise Death Risk in Older Non-Participants

Marathons are tied to an increased risk of death for older non-participants who suffer heart attacks and other life-threatening medical episodes within the vicinity of the event, claims a new study.

Researchers at Harvard Medical School analyzed Medicare data on hospitalizations for acute myocardial infarction (MI) or cardiac arrest in 11 U.S. cities hosting major marathons between 2002 and 2012. The researchers compared 30-day mortality among beneficiaries hospitalized on the date of a marathon, those who were hospitalized on the same day of the week as the day of the marathon in the 5 weeks before or after the marathon, and those who were hospitalized on the same day as the marathon, but in surrounding ZIP Code areas unaffected by the marathon.

The researchers also analyzed a U.S. registry of ambulance transports to investigate whether ambulance transports occurring before noon in marathon-affected areas (when road closures are likely) had longer scene-to-hospital transport times than on non-marathon dates. They also compared transport times on marathon dates with those on non-marathon dates in the same areas during evenings (when roads were reopened) and in areas unaffected by the marathon. In all, the analysis included 1,145 hospitalizations for MI or cardiac arrest at marathon-affected hospitals on marathon days, and 11,074 hospitalizations on non-marathon days.

The results revealed that daily frequency of hospitalizations was similar on marathon and non-marathon dates, but 30-day mortality rates in marathon-affected areas on marathon dates was 28.2%, compared to 24.9% on non-marathon dates. The pattern persisted after adjustment for covariates that included beneficiaries who had five or more chronic medical conditions. No significant differences were found with respect to where patients were hospitalized, or the treatments they received in the hospital. The study was published on April 13, 2017, in the New England Journal of Medicine (NEJM).

“Ambulance scene-to-hospital transport times for pickups before noon were 4.4 minutes longer on marathon dates than on non-marathon dates; no delays were found in evenings or in marathon-unaffected areas,” concluded lead author Anupam Jena, MD, PhD, of HMS, and colleagues. “No delays were found for evening transport or in areas unaffected by marathons. Taken together, our findings suggest that road closures, diversion of ambulance resources, and ensuing delays in hospital care may explain the higher mortality.”