Emergency physicians are often called upon to provide event coverage for marathons.
Prolonged endurance racing is safe for the majority of participants.
Hyponatremia (8.2% - 13.5%) - finishing times of greater than 4 hours is an independent risk factor
Hypokalemia – uncommon
Renal function – BUN > 30 or Cr > 1.4 mg/dL (23.6%). There is no data that this is of any clinical significance.
Cardiac Troponin - (11%) had significant increases (troponin T > or = 0.075 ng/mL or troponin I > or = 0.5 ng/mL). Elevations were more commonly seen with weight loss and increased Cr levels and may be associated with running inexperience (< 5 previous marathons) and young age (< 30 years) though interestingly not with race duration or traditional cardiac risk factors.
Findings are similar for men and women
References
Cardiac troponin increases among runners in the Boston Marathon.
.Ann Emerg Med. 2007 Feb;49(2):137-43
Prevalence of Hyponatremia, Renal Dysfunction, and Other Electrolyte Abnormalities Among Runners Before and After Completing a Marathon or Half Marathon
