Delays in emergency care and mortality during major U.S. marathons.
Open accessAbstract
BACKGROUND: Large marathons frequently involve widespread road closures and infrastructure disruptions, which may create delays in emergency care for nonparticipants with acute medical conditions who live in proximity to marathon routes. METHODS: We analyzed Medicare data on hospitalizations for acute myocardial infarction or cardiac arrest among Medicare beneficiaries (≥65 years of age) in 11 U.S. cities that were hosting major marathons during the period from 2002 through 2012 and compared 30-day mortality among the beneficiaries who were hospitalized on the date of a marathon, those who were hospitalized on the same day of the week as the day of the marathon in the 5 weeks before or the 5 weeks after the marathon, and those who were hospitalized on the same day as the marathon but in surrounding ZIP Code areas unaffected by the marathon. We also analyzed data from a national registry of ambulance transports and investigated whether ambulance transports occurring before noon in marathon-affected areas (when road closures are likely) had longer scene-to-hospital transport times than on nonmarathon dates. We also compared transport times on marathon dates with those on nonmarathon dates in these same areas during evenings (when roads were reopened) and in areas unaffected by the marathon. RESULTS: The daily frequency of hospitalizations was similar on marathon and nonmarathon dates (mean number of hospitalizations per city, 10.6 and 10.5, respectively; P=0.71); the characteristics of the beneficiaries hospitalized on marathon and nonmarathon dates were also similar. Unadjusted 30-day mortality in marathon-affected areas on marathon dates was 28.2% (323 deaths in 1145 hospitalizations) as compared with 24.9% (2757 deaths in 11,074 hospitalizations) on nonmarathon dates (absolute risk difference, 3.3 percentage points; 95% confidence interval, 0.7 to 6.0; P=0.01; relative risk difference, 13.3%). This pattern persisted after adjustment for covariates and in an analysis that included beneficiaries who had five or more chronic medical conditions (a group that is unlikely to be hospitalized because of marathon participation). No significant differences were found with respect to where patients were hospitalized or the treatments they received in the hospital. Ambulance scene-to-hospital transport times for pickups before noon were 4.4 minutes longer on marathon dates than on nonmarathon dates (relative difference, 32.1%; P=0.005). No delays were found in evenings or in marathon-unaffected areas. CONCLUSIONS: Medicare beneficiaries who were admitted to marathon-affected hospitals with acute myocardial infarction or cardiac arrest on marathon dates had longer ambulance transport times before noon (4.4 minutes longer) and higher 30-day mortality than beneficiaries who were hospitalized on nonmarathon dates. (Funded by the National Institutes of Health.).
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Patients with other time-sensitive, resource-intensive conditions including OHCAs were diverted from the ransomware-infected HDO to other hospitals.
“In addition to stroke victims, patients with other time-sensitive, resource-intensive conditions including out-of-hospital cardiac arrests (OHCAs) were diverted from the ransomware-infected HDO to other hospitals (6).”
From Ransomware Cyberattack Associated With Cardiac Arrest Incidence and Outcomes at Untargeted, Adjacent Hospitals (2024) · cites this paper as [6]
The Methods and Results (Analysis of Potential Causes; Possible Causes, page unavailable) examine possible hospital diversion during marathons and report that patients were not admitted to different hospitals. The copy does not address a ransomware-infected healthcare organization or whether its out-of-hospital cardiac arrest patients were diverted (searched: ransomware-related diversion and hospital diversion). (LLM, conf=0.77)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Emberson, J., Lees, K. R., Lyden, P., Blackwell, L., Albers, G., Bluhmki, E., Brott, T., Cohen, G., Davis, S., Donnan, G., et al. (2014) · The Lancet · doi:10.1016/s0140-6736(14)60584-5 · Cited by 2,737 · see citing works
Using the Margins Command to Estimate and Interpret Adjusted Predictions and Marginal Effects
Williams, R. A. (2012) · The Stata Journal Promoting communications on statistics and Stata · doi:10.1177/1536867x1201200209 · Cited by 2,193 · see citing works
Time Delay to Treatment and Mortality in Primary Angioplasty for Acute Myocardial Infarction
Luca, G. D., Suryapranata, H., Ottervanger, J. P., & Antman, E. M. (2004) · Circulation · doi:10.1161/01.cir.0000121424.76486.20 · Cited by 1,541 · see citing works
Cannon, C. P. (2000) · JAMA · doi:10.1001/jama.283.22.2941 · Cited by 1,221 · see citing works
Chalfin, D. B., Trzeciak, S., Likourezos, A., Baumann, B. M., & Dellinger, R. P. (2007) · Critical Care Medicine · doi:10.1097/01.ccm.0000266585.74905.5a · Cited by 1,022 · see citing works
Early Cardiopulmonary Resuscitation in Out-of-Hospital Cardiac Arrest
Hasselqvist‐Ax, I., Riva, G., Herlitz, J. D., Rosenqvist, M., Hollenberg, J., Nordberg, P., Ringh, M., Jonsson, M. N., Axelsson, C., Lindqvist, J., et al. (2015) · New England Journal of Medicine · doi:10.1056/nejmoa1405796 · Cited by 992 · see citing works
Delayed Time to Defibrillation after In-Hospital Cardiac Arrest
Chan, P. S., Krumholz, H. M., Nichol, G., & Nallamothu, B. K. (2008) · New England Journal of Medicine · doi:10.1056/nejmoa0706467 · Cited by 634 · see citing works
Luca, G. D., Suryapranata, H., Zijlstra, F., Hof, A. W. J. V. ’., Hoorntje, J. C. A., Gosselink, A. T. M., Dambrink, J. E., & de Boer, M. (2003) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(03)00919-7 · Cited by 468 · see citing works
Cardiovascular Events during World Cup Soccer
Wilbert-Lampen, U., Leistner, D. M., Greven, S., Pohl, T., Sper, S., Völker, C., Güthlin, D., Plasse, A., Knez, A., Küchenhoff, H., et al. (2008) · New England Journal of Medicine · doi:10.1056/nejmoa0707427 · Cited by 426 · see citing works
Goldberger, Z. D., Chan, P. S., Berg, R. A., Kronick, S. L., Cooke, C. R., Lu, M., Banerjee, M., Hayward, R. A., Krumholz, H. M., & Nallamothu, B. K. (2012) · The Lancet · doi:10.1016/s0140-6736(12)60862-9 · Cited by 403 · see citing works
Duration of Resuscitation Efforts and Functional Outcome After Out-of-Hospital Cardiac Arrest
Reynolds, J. C., Frisch, A., Rittenberger, J. C., & Callaway, C. W. (2013) · Circulation · doi:10.1161/circulationaha.113.002408 · Cited by 366 · see citing works
Admissions for myocardial infarction and World Cup football: database survey
Carroll, D., Ebrahim, S. B. J., Tilling, K., Macleod, J., & Smith, G. D. (2002) · BMJ · doi:10.1136/bmj.325.7378.1439 · Cited by 214 · see citing works
Goto, Y., Funada, A., & Goto, Y. N. (2016) · Journal of the American Heart Association · doi:10.1161/jaha.115.002819 · Cited by 186 · see citing works
Witte, D. R., Bots, M. L., Hoes, A. W., & Grobbee, D. E. (2000) · BMJ · doi:10.1136/bmj.321.7276.1552 · Cited by 170 · see citing works
Comparing Local and Regional Variation in Health Care Spending
Zhang, Y., Baik, S. H., Fendrick, A. M., & D, K. B. A. (2012) · New England Journal of Medicine · doi:10.1056/nejmsa1203980 · Cited by 156 · see citing works
Competing risks of mortality with marathons: retrospective analysis
Redelmeier, D. A., & Greenwald, J. A. (2007) · BMJ · doi:10.1136/bmj.39384.551539.25 · Cited by 106 · see citing works
Outcomes After Out-of-Hospital Cardiac Arrest Treated by Basic vs Advanced Life Support
Sanghavi, P., Jena, A. B., Newhouse, J. P., & Zaslavsky, A. M. (2014) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2014.5420 · Cited by 103 · see citing works
Mortality Among Marathon Runners in the United States, 2000-2009
Mathews, S. C., Narotsky, D. L., Bernholt, D. L., Vogt, M. N. P., Hsieh, Y., Pronovost, P. J., & Pham, J. C. (2012) · The American Journal of Sports Medicine · doi:10.1177/0363546512444555 · Cited by 100 · see citing works
Description of the 2012 NEMSIS Public-Release Research Dataset
Mann, N. C., Kane, L., Dai, M., & Jacobson, K. E. (2014) · Prehospital Emergency Care · doi:10.3109/10903127.2014.959219 · Cited by 84 · see citing works
Berthier, F., & Boulay, F. (2003) · Heart · doi:10.1136/heart.89.5.555 · Cited by 75 · see citing works
Outcomes of Basic Versus Advanced Life Support for Out-of-Hospital Medical Emergencies
Sanghavi, P., Jena, A. B., Newhouse, J. P., & Zaslavsky, A. M. (2015) · Annals of Internal Medicine · doi:10.7326/m15-0557 · Cited by 54 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Marijon, É., Narayanan, K., Smith, K. L., Barra, S., Basso, C., Blom, M. T., Crotti, L., d’Ávila, A., Deo, R., Dumas, F., et al. (2023) · The Lancet · doi:10.1016/s0140-6736(23)00875-9 · Cited by 329 · see citing works
A US National Study of the Association Between Income and Ambulance Response Time in Cardiac Arrest
Hsia, R. Y.-J., Huang, D., Mann, N. C., Colwell, C., Mercer, M. P., Dai, M., & Niedzwiecki, M. J. (2018) · JAMA Network Open · doi:10.1001/jamanetworkopen.2018.5202 · Cited by 101 · see citing works
Healthcare Challenges in the Era of Cybersecurity
Tully, J. L., Selzer, J., Phillips, J. P., O’Connor, P. M., & Dameff, C. J. (2020) · Health Security · doi:10.1089/hs.2019.0123 · Cited by 86 · see citing works
Ransomware attack associated with disruptions at adjacent emergency departments in the US.
Dameff, C., Tully, J., Chan, T. C., Castillo, E. M., Savage, S., Maysent, P., Hemmen, T. M., Clay, B. J., & Longhurst, C. A. (2023) · JAMA Network Open · doi:10.1001/jamanetworkopen.2023.12270 · Cited by 60 · see citing works
Racial/ethnic disparities in emergency department wait times in the United States, 2013–2017
Lu, F. Q., Hanchate, A. D., & Paasche‐Orlow, M. K. (2021) · The American Journal of Emergency Medicine · doi:10.1016/j.ajem.2021.03.051 · Cited by 52 · see citing works
Collateral damage – Impact of a pandemic on stroke emergency services
Desai, S. M., Guyette, F. X., Martin‐Gill, C., & Jadhav, A. P. (2020) · Journal of Stroke and Cerebrovascular Diseases · doi:10.1016/j.jstrokecerebrovasdis.2020.104988 · Cited by 47 · see citing works
“Widespread road closures caused by large marathons have been associated with delays in transfer of acute myocardial infarction (MI) patients, and hence have been attendant with increased 30-day mortality compared to admissions on non-marathon days.(2) Furthermore, departure from routine life, voluntary or reactionary,…”
BackgroundThe affordable care act and ambulance response times
Courtemanche, C., Friedson, A., Koller, A. P., & Rees, D. I. (2019) · Journal of Health Economics · doi:10.1016/j.jhealeco.2019.05.010 · Cited by 39 · see citing works
Kidney health for all: preparedness for the unexpected in supporting the vulnerable
Hsiao, L., Shah, K. M., Liew, A., Abdellatif, D. A., Balducci, A., Haris, A., Kumaraswami, L. A., Liakopoulos, V., Lui, S., Ulasi, I., et al. (2023) · Kidney International · doi:10.1016/j.kint.2022.12.013 · Cited by 36 · see citing works
“One study found that road closures and infrastructure disruptions during marathons increased the risk of death from heart attacks, as many people en route to hospitals were unaware of these closures beforehand.(13) Regardless of the scale of the event, it is important to prepare for unexpected events outside of natura…”
BackgroundUnmanned Aerial Vehicle Mediated Drug Delivery for First Aid
Sheng, T., Jin, R., Yang, C., Qiu, K., Wang, M., Shi, J., Zhang, J., Gao, Y., Wu, Q., Zhou, X., et al. (2022) · Advanced Materials · doi:10.1002/adma.202208648 · Cited by 34 · see citing works
Medical Tent Utilization at 10-km Road Races: Injury, Illness, and Influencing Factors
Breslow, R. G., Shrestha, S., Feroe, A. G., Katz, J. N., Troyanos, C., & Collins, J. E. (2019) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0000000000002068 · Cited by 34 · see citing works
Traffic congestion, transportation policies, and the performance of first responders
Brent, D. A., & Beland, L. (2020) · Journal of Environmental Economics and Management · doi:10.1016/j.jeem.2020.102339 · Cited by 37 · see citing works
MPC-Based Emergency Vehicle-Centered Multi-Intersection Traffic Control
Hosseinzadeh, M., Sinopoli, B., Kolmanovsky, I. V., & Baruah, S. (2022) · IEEE Transactions on Control Systems Technology · doi:10.1109/tcst.2022.3168610 · Cited by 31 · see citing works
“affects hospitalization and mortality rates [5].”
The Quality and Efficiency of Public and Private Firms: Evidence from Ambulance Services
Knutsson, D., & Tyrefors, B. (2022) · The Quarterly Journal of Economics · doi:10.1093/qje/qjac014 · Cited by 30 · see citing works
“%) faster, which is a considerable amount of time given that a time delay is a key detrimental factor in the health emergency literature (Jena et al., 2017; Lucchese, 2020).”
BackgroundFriedman, A. B., Barfield, D., David, G., Diller, T., Gunnarson, C. L., Liu, M., Vicidomina, B., Zhang, R., Zhang, Y., & Nigam, S. (2021) · Journal of the American College of Emergency Physicians Open · doi:10.1002/emp2.12349 · Cited by 27 · see citing works
Kocher, K. E., & Macy, M. L. (2020) · JAMA Health Forum · doi:10.1001/jamahealthforum.2020.0705 · Cited by 26 · see citing works
Lives vs. Livelihoods: The Impact of the Great Recession on Mortality and Welfare
Finkelstein, A. N., Notowidigdo, M. J., Schilbach, F., & Zhang, J. (2024) · National Bureau of Economic Research · doi:10.3386/w32110 · Cited by 24 · see citing works
The Gillette Stadium Experience: A Retrospective Review of Mass Gathering Events From 2010 to 2015
Goldberg, S. A., Maggin, J., Molloy, M. J., Baker, O. N., Sarin, R. R., Kelleher, M., Mont, K., Fajana, A., & Goralnick, E. (2018) · Disaster Medicine and Public Health Preparedness · doi:10.1017/dmp.2018.7 · Cited by 23 · see citing works
“As an example, a recent study suggested a negative impact of marathons on health outcomes in cardiac arrest patients located proximal to the event.(32) We would benefit from an understanding of the impacts of mass gathering events on local emergency departments, health care institutions, public safety systems, and com…”
ResultCOVID‐19 lockdown and traffic accidents: Lessons from the pandemic
Barnes, S. R., Beland, L., Huh, J., & Kim, D. (2021) · Contemporary Economic Policy · doi:10.1111/coep.12562 · Cited by 23 · see citing works
The impact of certificate of need laws on heart attack mortality: Evidence from county borders
Chiu, K. (2021) · Journal of Health Economics · doi:10.1016/j.jhealeco.2021.102518 · Cited by 23 · see citing works
Burden of Injury and Illness in the Road Race Medical Tent: A Narrative Review
Breslow, R. G., Giberson-Chen, C. C., & Roberts, W. O. (2020) · Clinical Journal of Sport Medicine · doi:10.1097/jsm.0000000000000829 · Cited by 21 · see citing works
Morimura, N., Mizobata, Y., Sugita, M., Takeda, S., Kiyozumi, T., Shoko, T., Inoue, Y., Otomo, Y., Sakurai, A., Koido, Y., et al. (2021) · Acute Medicine & Surgery · doi:10.1002/ams2.626 · Cited by 21 · see citing works
Impact of traffic, poverty and facility ownership on travel time to emergency care in Nairobi, Kenya
Fraser, M. S., Wachira, B. W., Flaxman, A. D., Lee, A., & Duber, H. C. (2020) · African Journal of Emergency Medicine · doi:10.1016/j.afjem.2019.12.003 · Cited by 19 · see citing works
“The extent of potential transportation delays due to traffic are important to understand, as prior studies have demonstrated that delays in transporting acutely ill or injured individuals from the field to a health facility adversely impacts mortality [12].”
BackgroundHospital treatment and patient outcomes: Evidence from capacity constraints
Kleiner, S. A. (2019) · Journal of Public Economics · doi:10.1016/j.jpubeco.2019.03.011 · Cited by 17 · see citing works
Farid, M. S., Tsugawa, Y., & Jena, A. B. (2021) · JAMA Network Open · doi:10.1001/jamanetworkopen.2021.3040 · Cited by 15 · see citing works
Cyber-Safety in Healthcare IOT
Sparrell, D. (2019) · ITU Kaleidoscope Academic Conference (ITU K) · doi:10.23919/ituk48006.2019.8996148 · Cited by 14 · see citing works
“Marathons affect patient care due to the ambulance delays (due to rerouting around the marathon) resulting in a statistically significant increase in the 30-day mortality rates [15].”
BackgroundJohnston, A. N. B., Wadham, J., Brown, J., Aitken, M., Ranse, J., Hutton, A. E., Richards, B., & Crilly, J. L. (2019) · Prehospital and Disaster Medicine · doi:10.1017/s1049023x18001206 · Cited by 14 · see citing works
“Mass-participation sporting events, such as marathons, are increasingly common forms of mass gatherings.(8,9) Mass gatherings often occur in well-established community spaces.”
BackgroundData Analytics: Factors of Traffic Accidents in the UK
Haynes, S., Estin, P. C., Lazarevski, S., Soosay, M., & Kor, A.-L. (2019) · International Conference on Dependable Systems, Services and Technologies (DESSERT) · doi:10.1109/dessert.2019.8770021 · Cited by 13 · see citing works
“Literature shows that ambulance response times are critical to the following: hospitalization, rehabilitation, and survival following an accident, stroke or heart attack [10, 11, 12].”
BackgroundCourtemanche, C., Friedson, A., & Rees, D. I. (2019) · JAMA Network Open · doi:10.1001/jamanetworkopen.2019.6419 · Cited by 13 · see citing works
Pham, T. T., Loo, T. M., Malhotra, A., Longhurst, C. A., Hylton, D., Dameff, C., Tully, J., Wardi, G., Sell, R. E., & Pearce, A. K. (2024) · Critical Care Explorations · doi:10.1097/cce.0000000000001079 · Cited by 14 · see citing works
Oyatani, K., Koyama, M., Himuro, N., Miura, T., & Ohnishi, H. (2023) · International Journal of Health Geographics · doi:10.1186/s12942-023-00328-5 · Cited by 11 · see citing works
“a significant impact on outcomes of patients with myocardial infarction [33].”
BackgroundHacking 9-1-1: Infrastructure Vulnerabilities and Attack Vectors
Goebel, M., Dameff, C. J., & Tully, J. L. (2019) · Journal of Medical Internet Research · doi:10.2196/14383 · Cited by 11 · see citing works
“Although the direct effects of 9-1-1 attacks on patient care have not been studied, we can infer from other data that delays in emergency care worsens outcomes [11].”
Stress-testing road networks and access to medical care
Schuster, H., Polleres, A., & Wachs, J. (2024) · Transportation Research Part A Policy and Practice · doi:10.1016/j.tra.2024.104017 · Cited by 10 · see citing works
Unveiling hidden risks in healthcare from flood-induced transportation disruption in Germany
Wassmer, J., Bryant, S., Schimansky, P., Keegan, L. T., Pregnolato, M., Kurths, J., Marwan, N., & Merz, B. (2025) · Communications Earth & Environment · doi:10.1038/s43247-025-02645-y · Cited by 10 · see citing works
“Evenbriefinterruptionsinaccesstocare can adversely affect patient outcomes 15 , while prolonged disruptions can undermine public trust and destabilize communities 16,17 .”
InfluentialChan, J. L., Constantinou, V., Fokas, J. A., Phillips, S. V. D., & Chiampas, G. (2019) · Prehospital and Disaster Medicine · doi:10.1017/s1049023x19004345 · Cited by 10 · see citing works
Understanding the impact of lockdowns on short-term excess mortality in Australia
Clarke, P., & Leigh, A. (2022) · BMJ Global Health · doi:10.1136/bmjgh-2022-009032 · Cited by 10 · see citing works
Timely and Non-Disruptive Response of Emergency Vehicles: A Real-Time Approach
Oza, P., & Chantem, T. (2021) · International Conference on Real-Time Networks and Systems (RTNS) · doi:10.1145/3453417.3453434 · Cited by 10 · see citing works
“With over 240 million 911 calls being made every year just in the US alone [1], emergency response vehicles (ERVs) often fail to meet their target response time due to congested roads and thereby affecting the hospitalization and mortality rates [15].”
BackgroundLives Versus Livelihoods: The Impact of the Great Recession on Mortality and Welfare
Finkelstein, A. N., Notowidigdo, M. J., Schilbach, F., & Zhang, J. (2025) · The Quarterly Journal of Economics · doi:10.1093/qje/qjaf023 · Cited by 9 · see citing works
Goiana-da-Silva, F., Madureira-Fonseca, D., Graça, D. T., de Almeida, M. M., Pinho, M. C., Sá, J., Moreira, R., Cabral, L., Pereira, N., Nunes, A. M., et al. (2025) · Frontiers in Public Health · doi:10.3389/fpubh.2025.1630933 · Cited by 9 · see citing works
Out-of-Hospital Cardiac Arrests During the Japanese Professional Baseball Championship Series
Onozuka, D., & Hagihara, A. (2018) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2018.02.038 · Cited by 9 · see citing works
Zhang, S., Wang, L., Shen, Y., Zhang, Y., Gao, Y., Xu, T., & Zhang, Z. (2024) · Habitat International · doi:10.1016/j.habitatint.2024.103198 · Cited by 8 · see citing works
Hanchate, A. D., Baker, W. B., Paasche‐Orlow, M. K., & Feldman, J. A. (2022) · BMC Health Services Research · doi:10.1186/s12913-022-08358-8 · Cited by 8 · see citing works
“4-minute longer transport time (and no significant difference in distance transported) [45].”
BackgroundSocial mass gathering events influence emergency medical services call volume
Kienbacher, C. L., Herkner, H., Alemu, F., Rhodes, J. M., Rasheed, N. A., Aldeghaither, I., Barnawi, E. E., & Williams, K. A. (2024) · Frontiers in Public Health · doi:10.3389/fpubh.2024.1394384 · Cited by 8 · see citing works
Chiba, T., Takaku, R., Ito, E., Tamune, H., Rivera, M., Ikeda, S., & Shiga, T. (2023) · BMJ Open · doi:10.1136/bmjopen-2022-065466 · Cited by 7 · see citing works
Anemia in Athletes, News on Iron Therapy, and Community Care During Marathons
Eichner, E. R. (2018) · Current Sports Medicine Reports · doi:10.1249/jsr.0000000000000435 · Cited by 7 · see citing works
“However, the new study suggests a risk for those in the community hosting the marathon, especially older people who face delays in emergency health care (10).”
BackgroundPeters, G. A., Ordoobadi, A. J., Cash, R. E., Wong, M. L., Avillach, P., & Camargo, C. A. (2020) · JAMA Network Open · doi:10.1001/jamanetworkopen.2020.25586 · Cited by 6 · see citing works
Lucchese, E. (2023) · Health Economics · doi:10.1002/hec.4791 · Cited by 6 · see citing works
Zheng, L., Lin, P., Liang, M., Wang, C., Li, Y., Sun, J., Han, Y., & Liu, H. (2024) · IEEE/ASME Transactions on Mechatronics · doi:10.1109/tmech.2024.3442782 · Cited by 5 · see citing works
Johnston, A. N. B., Byrne, J. H., Bost, N., Aitken, M., Wadham, J., Donnelly, T., Timms, J., & Crilly, J. L. (2020) · Emergency Medicine Australasia · doi:10.1111/1742-6723.13609 · Cited by 5 · see citing works
“MGEs have the potential to induce delayed responses to (health) emergencies(3) due to a number of challenges, primarily related to the environment and patient egress.(1,4) MGEs present broad challenges in the context of increasing demands on health services, especially emergency health services, and the consequential…”
BackgroundNotfallmedizinische Aspekte bei Laufveranstaltungen
Finke, S.-R., Jänig, C. W., Deschler, A., Hanske, J., Herff, H., Hinkelbein, J., Böttiger, B. W., Schmidbauer, W., & Schroeder, D. C. (2021) · Notfall + Rettungsmedizin · doi:10.1007/s10049-021-00959-w · Cited by 5 · see citing works
The Impact of Delayed Symptomatic Treatment Implementation in the Intensive Care Unit
Meng, L., Laudański, K., Restrepo, M., Huffenberger, A. M., & Terwiesch, C. (2021) · Healthcare · doi:10.3390/healthcare10010035 · Cited by 5 · see citing works
Trial of Sportswear Type ECG Sensor Device for Cardiac Safety Management during Marathon Running
Yamane, T., Hirano, K., Hirai, K., Ousaka, D., Sakano, N., Morita, M., Oozawa, S., & Kasahara, S. (2022) · Advanced Biomedical Engineering · doi:10.14326/abe.11.151 · Cited by 5 · see citing works
Occurrence of the Mass Casualty Incident at a Mass Gathering Event
Peters, G. A., & Goralnick, E. (2024) · Cambridge University Press eBooks · doi:10.1017/9781009105156.024 · Cited by 4 · see citing works
The Effect of All-Terrain Vehicle Crash Location on Emergency Medical Services Time Intervals
Wubben, B. M., Denning, G. M., & Jennissen, C. A. (2019) · Safety · doi:10.3390/safety5040073 · Cited by 4 · see citing works
Hospital Closures and Short-Run Change in Ambulance Call TimesPreprint
Chaudhary, S., Davis, A. F., Troske, K. R., & Troske, S. (2019) · SSRN Electronic Journal · doi:10.2139/ssrn.3495774 · Cited by 4 · see citing works
A New Racial Disparity in Traffic FatalitiesPreprint
Chalfin, A. J., & Massenkoff, M. (2022) · SSRN Electronic Journal · doi:10.2139/ssrn.4276098 · Cited by 4 · see citing works
Venous thromboembolism and acute cardiovascular events: A focus on mass gatherings
Muchaili, L., Mulamfu, S., Chama, G. C., Sinamwenda, E. N., Chakulya, M., Mweene, B. C., Liweleya, S., Siame, L., & Masenga, S. K. (2025) · Mass gathering medicine. · doi:10.1016/j.mgmed.2025.100015 · Cited by 3 · see citing works
Organ Donation and Transplants During Major US Motorcycle Rallies
Cron, D. C., Worsham, C. M., Adler, J. T., Bray, C. F., & Jena, A. B. (2022) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2022.5431 · Cited by 3 · see citing works
Impact of Severe Winter Weather on Operations of a Radiation Oncology Department
Fekrmandi, F., Gill, J., Suresh, S., Hewson, S., & Chowdhry, V. K. (2024) · Advances in Radiation Oncology · doi:10.1016/j.adro.2024.101491 · Cited by 3 · see citing works
Guzmán-Tordecilla, D. N., & Trujillo, A. J. (2025) · Social Science & Medicine · doi:10.1016/j.socscimed.2025.117953 · Cited by 2 · see citing works
Retrospective Study for the Safer Management for Citizens' Marathon: A Medical Support Perspective
Ogawa, F., Nakayama, R., Nakayama, Y., Yuasa, Y., Kanagata, T., Takahashi, K., Furuya, R., Imaki, S., & Takeuchi, I. (2025) · Cureus · doi:10.7759/cureus.87424 · Cited by 2 · see citing works
“These events can strain local healthcare systems, especially when dependent on emergency medical services (EMS), potentially compromising community care [4-6].”
Taguchi, A., Aso, S., Yamagami, H., & Yasunaga, H. (2025) · Acute Medicine & Surgery · doi:10.1002/ams2.70050 · Cited by 2 · see citing works
“4,5,21 However, contrary to our findings, a previous single-center observational study showed that crowding in emergency departments was not associated with the outcomes of OHCA.”
G20 Summit and emergency medical services in Osaka, Japan
Tanaka, K., Morikawa, K., Katayama, Y., Kitamura, T., Sobue, T., Nakao, S., Nitta, M., Iwami, T., Fujimi, S., Uejima, T., et al. (2021) · Acute Medicine & Surgery · doi:10.1002/ams2.661 · Cited by 2 · see citing works
Fernandes, N. (2020) · Acta Médica Portuguesa · doi:10.20344/amp.14316 · Cited by 2 · see citing works
Income and Ambulance Response Time Inequality
Friedson, A. (2018) · JAMA Network Open · doi:10.1001/jamanetworkopen.2018.5201 · Cited by 1 · see citing works
Quantifying inter-agency coordination impacts on highway network recovery after disruptions
Virtucio, M. B., Zhao, B., Iwama, M., & Soga, K. (2026) · Transportation Research Part D Transport and Environment · doi:10.1016/j.trd.2026.105351 · Cited by 1 · see citing works
Using quality improvement to optimize neonatal transport team process metrics for critical transfers
Mannan, J., Simoncini, L., Allcroft, T. J., Shenoy, A. B., Jacob, A., & Rhein, L. M. (2026) · Pediatric Research · doi:10.1038/s41390-026-04966-w · Cited by 1 · see citing works
Pasternak, A. V., & Krabak, B. J. (2020) · Springer eBooks · doi:10.1007/978-3-030-36790-9_3 · Cited by 1 · see citing works
Briggs, S. J., & Boonstoppel, S. L. (2024) · Justice Quarterly · doi:10.1080/07418825.2024.2360009 · Cited by 1 · see citing works
“Based on previous research finding ambulance response times are elongated during marathons (Anupam et al., 2017), we evaluated whether these events also impact police response times to reported crimes.”
Fukuoka, H., Matsuura, H., Yanagi, H., & Oda, J. (2024) · Cureus · doi:10.7759/cureus.65410 · Cited by 1 · see citing works
“…as an increase in mortality rates of patients due to acute myocardial infarction or cardiac arrest that occurred in the vicinity during major marathons [5], changes in emergency transport times during the G20 summit in Osaka [6], and an increase in emergency calls in an event area in Finland [7].”
BackgroundAlternative effects of transportation time on out-of-hospital cardiac arrests
Patterson, C., Pitts, S. R., & Akhter, M. (2017) · Resuscitation · doi:10.1016/j.resuscitation.2017.05.019 · Cited by 1 · see citing works
Reply to alternative effects of transportation time in out-of-hospital cardiac arrests
Géri, G., & Lin, S. (2017) · Resuscitation · doi:10.1016/j.resuscitation.2017.06.008
Leaders Weigh In on Vulnerability Disclosure and the Changing Cyberthreat Landscape
Murthy, V., & Kijewski, M. (2019) · Biomedical Instrumentation & Technology · doi:10.2345/0899-8205-53.2.136
マラソン・ロードレースにおける救護・医療体制整備指針案について
一柳保, 晴山, 田., 智也, 喜., 裕, 北., 大迫幹生, 加百正人, 大木哲郎, 岡本, 征., 雅庸, 津., & 宏, 野. (2019) · 日本臨床救急医学会雑誌 · doi:10.11240/jsem.22.613
It Could Be Worse...It Could Be Raining: Ambulance Response Time and Health OutcomesPreprint
Lucchese, E. (2022) · SSRN Electronic Journal · doi:10.2139/ssrn.4207853
An Analysis of the Effect of Saturday Home Football Games on Physical Use of University Libraries
Sewell, K. B. (2021) · Evidence Based Library and Information Practice · doi:10.18438/eblip29942
“…services and outcomes serve as examples of how such tests can lead to better decisions about service delivery and staffing (Drobatz et al., 2009; Jena et al., 2017; Jerrard, 2009; Lo et al., 2012; McGreevy et al., 2010; Protty et al., 2016; Schuld et al., 2011; Shook & Hiestand, 2011; Smith &…”
BackgroundMorimura, N., Mizobata, Y., Sugita, M., Takeda, S., Otomo, Y., Yamaguchi, Y., Sakamoto, T., Inokuchi, M., Yokota, H., Tanaka, H., et al. (2022) · Journal Européen des Urgences et de Réanimation · doi:10.1016/j.jeurea.2022.11.003
Kidney health for all: preparedness for the unexpected in supporting the vulnerable
Hsiao, L., Shah, K. M., Liew, A., Abdellatif, D. A., Balducci, A., Haris, Á., Kumaraswami, L. A., Liakopoulos, V., Lui, S., Ulasi, I., et al. (2023) · Nephrology (Saint-Petersburg) · doi:10.36485/1561-6274-2023-27-2-12-20
Dehghani, A., Bahmanshpour, F., Anami, S., Masoumi, G., & Eskandari, Z. (2024) · Research Square · doi:10.21203/rs.3.rs-4032495/v1
Nishimura, T., Taira, T., Suga, M., Ijuin, S., Inoue, A., & Ishihara, S. (2024) · Resuscitation Plus · doi:10.1016/j.resplu.2024.100748
“8 Additionally, the high level of international interest in a mass gathering event like the Olympic/Par-alympic Games is associated with the potential for mass casualty incidents.”
BackgroundExtending the reach of the common cause design using meta-analytic methods: Applications and issues
Thompson, C. G., Yeaton, W. H., Velasquez, G., Petrova, K., & Becker, B. J. (2024) · Methodology · doi:10.5964/meth.10591
Retrospective Study for Safer Management for Citizen’s Marathon: A Medical Support PerspectivePreprint
Ogawa, F., Nakayama, R., Nakayama, Y., Yuasa, Y., Kanagata, T., Takahashi, K., Furuya, R., Imaki, S., & Takeuchi, I. (2025) · medRxiv · doi:10.1101/2025.02.05.25321727
Cybersecurity Challenges of Digital Health and AI in Healthcare
Abo, A. M., & Lantzy, S. (2025) · Springer eBooks · doi:10.1007/978-3-031-83526-1_13
Ho, P.-H., Ou, J., Ma, H., Wong, C., Lin, H.-C., & Hsu, C.-H. (2025) · Scientific Reports · doi:10.1038/s41598-025-99263-7
Apiratwarakul, K., Cheung, L. W., Pearkao, C., Khemtong, S., & Ienghong, K. (2025) · Risk Management and Healthcare Policy · doi:10.2147/rmhp.s545374
“A key 21,22 For instance, when motorlances were utilized as first responders, the average duration from activation to definitive care decision was 14.2 minutes, in contrast to traditional ambulance-only responses, which averaged 16.72 minutes during the routine period of a prior study.”
InfluentialClarke, P., Hua, X., Coleman, R. L., Chalmers, J. P., Woodward, M., Green, J. B., McGuire, D. K., Lim, L.-L., Adler, A., & Holman, R. R. (2025) · Diabetes Care · doi:10.2337/dc25-0541
Lognenko, M. M. (2025) · Population and Economics · doi:10.3897/popecon.9.e147200
“…medical services (EMS) and mortality, ambulance response time has been found to be significantly associated with 30-day mortality following hospitalization: the longer the waiting time, the higher the likelihood of death within 30 days (Gold et al. 2010; Boniatti et al. 2014; Jena et al. 2017).”
InfluentialCarenzo, L., Bermon, S., Bigard, X. A., Hudson, K. B., Garrandes, F., Migliorini, S., Sedgley, M. D., Troyanos, C., Pustel, C., & Adami, P. E. (2025) · Sports Medicine - Open · doi:10.1186/s40798-025-00959-x
Oyatani, K., Koyama, M., Himuro, N., Miura, T., & Ohnishi, H. (2024) · Figshare · doi:10.6084/m9.figshare.26579411
Hanchate, A. D., Baker, W. B., Paasche‐Orlow, M. K., & Feldman, J. A. (2022) · Figshare · doi:10.6084/m9.figshare.20423702
Optimizing the circuit: A critical enhancement at the 2025 NYC Marathon
Fitzpatrick, C. B., Groden, P., Carroll, M. T., Saunders, P. C., & Friedman, M. S. (2026) · The American Journal of Emergency Medicine · doi:10.1016/j.ajem.2026.02.009
Cron, D. C., Worsham, C. M., Bray, C. F., & Jena, A. B. (2026) · BMJ · doi:10.1136/bmj-2026-100320
- Authors
- Jena, A. B., Mann, N. C., Wedlund, L. N., & Olenski, A.
- Affiliations
- National Bureau of Economic Research (US)
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2017-04-13
- Volume
- 376
- Issue
- 15
- Pages
- 1441-1450
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- PMC
- PMC5558156
- OpenAlex
- W2606921773
- Cited by
- 91
- References
- 21
- Citations by year
- 2026: 4 · 2025: 14 · 2024: 14 · 2023: 7 · 2022: 11 · 2021: 11 · 2020: 10 · 2019: 13 · 2018: 5 · 2017: 2
- FWCI
- 10.43
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (DP5OD017897)
- Topics
- Health Sciences › Medicine › Emergency Medicine › Trauma and Emergency Care Studies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Acute Myocardial Infarction Research
- Health Sciences › Medicine › Emergency Medicine › Emergency and Acute Care Studies
- Keywords
- marathon running, 30-day mortality, acute myocardial infarction, cardiac arrest, road closures, hospitalization, Medicare beneficiaries, older adults, emergency medical services
- MeSH terms
- Aged, Ambulances, Emergency Medical Services, Female, Medicare, Heart Arrest, Hospitalization, Humans, Male, Myocardial Infarction, Registries, Running, Transportation of Patients, United States, Time-to-Treatment
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
