| Abstract ID |
| 20260085 |
| Category |
| Sports Medicine: Epidemiology and Injury Prevention |
| Preferable Presentation |
| Both |
| Title |
| RETROSPECTIVE STUDY OF MEDICAL ENCOUNTERS DURING THE AMAZING THAILAND MARATHON 2025 |
| Author |
|
| Presenter |
| Smon CHeewapansri |
| Abstract |
| Background Mass-participation running events have been exponentially growing globally, yet the existing risk stratification guidelines are predominantly derived from data in temperate climates (North America and Europe) with different demographics. While general injury rates for marathons are well-documented (6.2–14.7 per 1,000 finishers), the interaction between extreme heat, humidity, and runner demographics—specifically age and race distance—creates a unique risk profile. This massive gap of knowledge, for instance, the prevalence of Exercise-Associated Collapse (EAC) and heat-related illness in high-humidity settings may be crucial in providing a distinct triage protocols compared to cooler climates for the safety and care of the participants. Objective: This study addresses this gap of knowledge by providing a large-scale, retrospective epidemiological analysis of 46,964 runners at the Amazing Thailand Marathon. By identifying statistically significant risk factors across varying distances (4.5, 10.5, 21 km, and 42.195 km), this research aims to establish evidence-based benchmarks for medical resource planning in tropical mass-participation events. Methods: A retrospective analysis was done on valid medical record forms from 136 medical encounter cases recorded at the medical center with total registered participants in the Amazing Thailand Marathon 2025. Medical encounters were recorded with time stamps as they enter the medical tent for traffic and were categorized into trauma (musculoskeletal/wounds) and medical illnesses. The relationships between medical conditions, injury rates, race distance, and runners’ demographics were analyzed for statistical significances by using Chi-square goodness-of-fit and Fisher’s exact tests. Results: The overall medical encounter rate was 0.29% (136/46,964). Medical tent traffic analysis showed highest traffic at two to three hours after the start of the half and full marathons. Race distance was a highly significant predictor of injury (p < 0.00001), with the 42.195 km cohort demonstrating a disproportionately high injury rate of 0.78%, nearly 2.7 times the event average. Age was also a significant risk factor (p = 0.0055); runners aged 20–29 years had the highest susceptibility (0.47%), while the 40–49 age group exhibited a protective effect against injury. Analysis of injury types revealed a "distance threshold" for musculoskeletal pathology. Calf injuries were non-existent in short distances, such as 4.5 and 10.5 km but became the predominant pathology in the half and full marathons (p < 0.05). Conversely, wound analysis indicated a 3:1 prevalence of upper-body vs. lower-body injuries, suggesting falls rather than friction as the primary mechanism. Among medical diagnoses, Exercise-Associated Collapse was significantly driven by distance (p = 0.043), with marathon runners facing a 2.4-fold increased risk compared to the general cohort. Notably, hypothermia was identified as an exclusive risk for the 42.195 km distance (p = 0.0027). Conclusion: While the overall medical usage rate was low, the full marathon distance carries a distinct physiological burden that significantly alters the injury profile compared to shorter distaces. Medical resources for the 42 km route should prioritize management for collapse and hypothermia, while the 20–29 age demographic warrants increased surveillance for exertion-related injuries. These findings suggest that medical planning could be stratified by both distance and age to optimize runners’ safety in the future marathons. |