Abstract
Background: Approximately 10million people enjoy running in Japan annually. It is reported that the risk of an out-of-hospital cardiac arrest (OHCA) is temporarily increased during running. Several races in Japan supported by Running Doctors (RD) respond to runners with OHCA. The RDs are doctors who belong to the Japan Medical Joggers Association. The RDs participate in running races as general runners, perform medical monitoring from the inside of the running course, and if they encounter a serious health problem, especially OHCA, with a runner, they cancel their race and make an initial response. For example, 49 RDs cooperated in Tokyo Marathon 2019. However, the effectiveness of their activities is unclear. We investigated whether their activities were effective. Methods: A cohort of 8,884 patients with OHCA were admitted with return of spontaneous circulation (ROSC) or on-going resuscitation at our hospital arrival from 2006 to 2018. The 13 runners with OHCA which occurred during long distance running races were analyzed from the medical records and interviews of survivors and relatives. We divided runners into two groups depending on whether RD responded: RD group (n=7) and non-RD group (n=6). The clinical outcome was 30-day survival with minimal neurologic impairment. Results; Overall, the 12 (92%) runners were male. The RD group was older than Non-RD group (RD vs. Non-RD, 52±9 vs. 35±17 years old; P=0.04). The time interval between collapse and starting cardiopulmonary resuscitation (0.4±0.5 vs. 4.2±3.6 min; P=0.02) and between collapse and ROSC (6.6±2.9 vs. 23.3±19.3 min ; P=0.04) were significantly shorter in RD group. On Kaplan-Meier analysis, runners with OHCA in RD group were better clinical outcome than Non-RD group (100% vs. 67%; P=0.11; log-rank test). (Figure) Conclusion; The long-distance running races supported by running doctors provided early response to runners with OHCA. This might lead to better clinical outcomes for runners with OHCA.
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