Medical Encounters and Treatment Outcomes in Ironman-Distance Triathlon

Abstract

ABSTRACT Purpose This study aimed to examine the injury and illness characteristics, treatments, and outcomes at elite ultraendurance triathlon events. Methods We quantified participant demographics, injury types, treatments, and disposition for medical encounters at 27 Ironman-distance triathlon championships from 1989 to 2019. We then calculated the likelihood of concurrent medical complaints in each encounter. Results We analyzed 10,533 medical encounters among 49,530 race participants for a cumulative incidence of 221.9/1000 participants (95% confidence interval [CI] = 217.7–226.2). Younger (<35 yr; 259.3/1000, 95% CI = 251.6–267.2) and older athletes (70+ yr; 254.0/1000, 95% CI = 217.8–294.4) presented to the medical tent at higher rates than middle-age adults (36–69 yr; 180.1/1000, 95% CI = 175.4–185.0). Female athletes also presented at higher rates when compared with males (243.9/1000, 95% CI = 234.9–253.2 vs 198.0/1000, 95% CI = 193.4–202.6). The most common complaints were dehydration (438.7/1000, 95% CI = 426.2–451.6) and nausea (400.4/1000, 95% CI = 388.4–412.6). Intravenous fluid was the most common treatment (483/1000; 95% CI = 469.8–496.4). Of the athletes who received medical care, 116.7/1000 (95% CI = 110.1–123.4) did not finish the race, and 17.1/1000 (95% CI = 14.7–19.8) required hospital transport. Athletes rarely presented with an isolated medical condition unless their injury was dermatologic or musculoskeletal in nature. Conclusions Ultraendurance triathlon events have high rates of medical encounters among female athletes, as well as both younger and older age categories. Gastrointestinal and exertional-related symptoms are among the most common complaints. Intravenous infusions were the most common treatment after basic medical care. Most athletes entering the medical tent finished the race, and a small percentage were dispatched to the hospital. A more thorough understanding of common medical occurrences, including concurrent presentations and treatments, will allow for improved care and optimal race management.