Browsing by Author "Jordaan, Esmè"

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    A high incidence of serious life-threatening cardiovascular medical encounters during a marathon (2014–2019) calls for prevention strategies: SAFER XL
    (Taylor and Francis Ltd., 2024) Jordaan, Esmè; Green, Darren; Sewry, Nicola; Derman, Wayne
    Objective: The aim of this study was to determine the incidence and nature (severity and type by organ system and specific diagnosis) of all medical encounters (MEs), including serious/life-threatening MEs (SLMEs) during a South African road marathon. Methods: This descriptive study was a retrospective analysis of data collected over 6 years at the Cape Town Marathon from 2014 to 2019, which included 40 446 starters. All MEs were collected and described as per the consensus statement for mass community-based sporting events. Incidences (I; per 1000 starters; 95% CI) are described for all MEs, SLMEs, and by organ system and specific diagnosis. Results: The incidence of all MEs was 8.7 (95% CI: 7.8–9.6) per 1000 starters. The largest contributor to all MEs, by organ system affected, was cardiovascular-related, with an incidence of 1.8 (95% CI: 1.4–2.2), where exercise-associated postural hypotension was the most common specific diagnosis (I = 1.3; 95% CI: 1.0–1.7). The incidence of all SLMEs was 1.0 (95% CI: 0.7–1.4) making up 11.7% (41/350) of all MEs. The incidence of SLMEs by organ system was highest in the cardiovascular system (I = 0.4; 95% CI: 0.3–0.7), with acute coronary syndrome (ACS) (I = 0.2; 95% CI: 0.1–0.4) the most common specific diagnosis. There were no sudden cardiac deaths (SCD) nor sudden cardiac arrests (SCA). Conclusion: There was a high proportion of cardiovascular-related medical encounters, as well as SLMEs. We recommend that event organizers and race medical directors investigate prevention strategies to mitigate against risk of SLMEs, specifically acute cardiovascular SLMEs.
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    Years of running, chronic diseases, and allergies are associated with gradual onset achilles tendon injuries in 61,252 running race entrants: SAFER XXXIX study
    (John Wiley and Sons Inc, 2024) Young, Jonah; Jordaan, Esmè; Wood, Paola
    Background: Gradual-onset achilles tendon injuries (GoATIs) in runners are common. Data show that chronic diseases are associated with GoATI. Objective: To determine risk factors associated with a history of GoATIs among long-distance runners (21.1 and 56 km) entering a mass community-based running event. Methods: Online pre-race medical screening questionnaire data from 76,654 consenting Two Ocean Marathon race entrants (71.8% entrants) were collected prospectively over 4 years (2012–2015); this cross-sectional study is a retrospective analysis of these data. A total of 617 entrants (0.8%) reported a GoATI in the last 12 months; 60,635 entrants reported no history of any running injury (controls). Categories of factors associated with GoATI were explored (univariate and multiple regression analyses): demographics (age group, sex, race, distance), training/racing history, and history of allergy, history of chronic disease, and composite chronic disease score. Prevalence and prevalence ratios (PRs; 95% CI) are reported. Results: Factors associated with a higher prevalence of a history of GoATI (univariate analysis vs. controls) were older age (>31 years) (p <.001), male sex (PR = 1.76; p <.001), and longer race distance (56 km vs. 21.1 km) (PR = 2.06; p <.001). Independent factors associated with a history of GoATI (multiple regression) were increased years of recreational running (PR = 1.17 for every 5-year increase, p <.001), higher composite chronic disease score (PR = 2.07 for every 2-unit increase, p <.001), and allergy history (PR = 1.98 p <.001). Conclusion: Novel independent factors associated with a history of GoATI in distance runners were increased years of recreational running, chronic disease history, and allergy history. Runners at risk for GoATI could be targeted for injury prevention interventions. Future studies should focus on establishing a causal relationship.