PURPOSE: Due to an increased interest in health, there have been many types of marathon races for athletes and the general population. Marathon is an extremely difficult sport, therefore, many running injuries can occur. In this study, we aimed at characterization of injuries and clinical courses resulting from marathon induced heat stroke. Based on our findings, we provide suggestions for proper management of patients with marathon induced heat stroke. METHODS: We performed a retrospective study of 24 patients who visited the emergency department (ED) at Yeouido St. Mary's hospital between January 2000 and August 2011 with symptoms of heat stroke resulting from participation in a marathon race. We reviewed the medical records, which showed clinical presentation and laboratory findings. RESULTS: Of the 24 patients, 20(83.3%) were men. Their average age was 38.1+/-8.4 years old and their average initial rectal temperature was 39.9+/-1.3degrees C. Seventeen (70.8%) patients came to the ED complaining of syncope and seven(29.2%) came because of mental change. In follow-up laboratory tests, ten patients showed an increased level of serum Creatine phosphokinase (CPK) to over 1,000 IU/L, six showed serum Aspartate aminotransferase (AST)/Alanine aminotransferase (ALT) to over 300 IU/L, four showed serum creatinine to over 2.0 mg/dL, and two showed an increase in serum troponin-I and MB fraction of creatine kinase. Results of initial laboratory tests showed normal AST/ALT levels, however, they started to rise between 12 to 24 hours, and reached the highest record after 2~3 days of hospitalization. CONCLUSION: Marathon induced heat stroke can cause various complications, such as rhabdomyolysis, acute hepatic injury, acute renal failure, and metabolic acidosis. Therefore, we recommend follow-up and observation for patients with marathon induced heat stroke.
Acidosis ; Acute Kidney Injury ; Aspartate Aminotransferases ; Athletes ; Continental Population Groups ; Creatine Kinase ; Creatinine ; Emergencies ; Follow-Up Studies ; Heat Stroke ; Hot Temperature ; Humans ; Male ; Medical Records ; Porphyrins ; Retrospective Studies ; Rhabdomyolysis ; Running ; Sports ; Syncope ; Troponin I

Objective: This aim examined the outcomes of resuscitation and the clinical characteristics of patients with pre-hospitaltraumatic cardiac arrests (TCA). Methods: The charts of patients with pre-hospital TCA who visited the various emergency department (ED) in Gangwondofrom January 2013 to December 2017 were reviewed retrospectively. Results: TCA patients comprised 0.3% of patients transferred by 119. A total of 367 patients were enrolled in the study.Traffic accidents were the leading cause of the arrest. The initial field and ED rhythm were mostly asystole (field, 79.6%;ED, 82.3%). It took 11.24±9.95 minutes from the call to the field. From the field to ED, it took 22.87±15.37 minutes. Thetotal CPR time before ED arrival was 21.62±15.29 minutes. The causes of TCA were brain injury (35.7%), hypovolemicshock (29.2%), and severe lung injury (16.3%). Seventy TCA patients experienced at least one return of spontaneous circulation(ROSC). Twenty-six patients (7.14%) were admitted to the ward, and their average injury severity score was38.96. Eight patients expired before 12 hours after transient ROSC. Four more patients expired before 24 hours. Fourpatients were discharged alive among patients who lived for more than 24 hours. Conclusion In this study, 1.5% of patients were discharged alive. The possibility of ROSC was higher as the time to ED,and the cardiopulmonary resuscitation time of 119 was shorter. Pulseless electrical activity rather than asystole tends topromote ROSC. The survival rate increased when ROSC occurred before arriving at the ED.