Browsing by Author "Sewry, Nicola"

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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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    Pre-race screening and stratification predicts adverse events—A 4-year study in 29585 ultra-marathon entrants, SAFER X
    (Wiley-Blackwell, 2020) Jordaan, Esmé R.; Sewry, Nicola; Schwellnus, MP
    Pre-race screening and risk stratification in recreational endurance runners may predict adverse events (AEs) during a race. Aim: To determine if pre-race screening and risk stratification predict AEs during a race. Methods: A total of 29 585 participants (Male 71.1%, average age = 42.1 years; Female 28.9%, average age = 40.2 years) at the Two Oceans ultra-marathon races (56 km) completed a pre-race medical screening questionnaire and were risk stratified into four pre-specified groups [very high risk (VHR; existing cardiovascular disease–CVD:3.2%), high risk (HR; risk factors for CVD:10.5%), intermediate risk (IR; existing other chronic disease, medication use or injury:53.3%), and low risk (LR:33.0%)]. Race starters, finishers, and medical encounters (ME) were recorded. Did-not-start (DNS) rate (per 1000 entrants that did-not-start), did-not-finish (DNF) rate (per 1000 starters that did-not-finish), AE rate [per 1000 starters that either DNF or had an ME], and ME rate (per 1000 starters with an ME) were compared across risk categories. Results: Adverse events were significantly higher (per 1000 starters; 95%CI) in the VHR (68.9; 52.4-89.9:P =.0407) compared with the LR (51.3; 46.5-56.7).
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    Pre-race self-reported medical conditions and allergies in 133 641 Comrades ultramarathon (90km) runners - SAFER XXIII
    (The Physician and Sportsmedicine, 2023) Jordaan, Esme; Brill, Stephan; Schwellnus, Martin; Sewry, Nicola
    Objectives: To determine the prevalence of self-reported pre-race chronic medical conditions and allergies in ultramarathon race entrants and to explore if these are associated with an Increased risk of race-day medical encounters (MEs). Methods: Data from two voluntary open-ended pre-race medical screening questions (Q1 – history of allergies; Q2 - history of chronic medical conditions/prescription medication use) were collected in 133 641 Comrades Marathon race entrants (2014-2019). Race-day ME data collected prospectively over 6 years are reported as incidence (per 1000 starters) and incidence ratios (IR: 95%CI’s).
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    Predictors of multiple injuries in individual distance runners: A retrospective study of 75,401 entrants in 4 annual races- safer xxx
    (Elsevier, 2022) Swanevelder, Sonja; Sewry, Nicola; Jordaan, Esme
    There are limited data on factors that predict an increased risk of multiple injuries among distance runners. The objective of this study was to determine risk factors that are predictive of individual runners with a high annual multiple injury risk (MIR). A retrospective, cross-sectional study at 4 annual (2012–2015) Two Oceans 21.1 km and 56.0 km races in South Africa with 75,401 consenting race entrants. Running-related injury data were collected retrospectively through an online pre-race medical screening questionnaire. The average number of injuries for each runner every year was calculated by taking a runner's race entry history and injury history into account and categorizing entrants into 4 MIR categories (high, intermediate, low, and very low (reference)).