S. P. Cho1, C. P. Connolly1, T. K. Miller2, R. Laird3 & W. D. B. Hiller1

1Washington State University, Pullman, WA, 2Virginia Tech Carilion School of Medicine, Roanoke, VA, 3Kona Community Hospital, Kona, HI

Ironman-distance events are three-sport ultra-endurance competitions. Due to its rigorous physiologic demands, various adverse medical incidents occur among competitors. Some athletes compete in the same event over multiple and successive years; however, medical trends among repeat competitors have not been previously investigated. PURPOSE: To determine medical trends for nausea, vomiting, dizziness, muscle cramps, diarrhea, and hyponatremia for repeat competitors in a single longstanding Ironman-distance event. METHODS: Standardized data sheets with common adverse medical incidents were completed by registered nurses and physicians upon athlete check-in to the medical tent at the event between the years of 1989-2019. Competitors (N=51) were included for analysis within the current investigation if admitted to the tent for at least five competitions within a fifteen-year span and if they were under 35 years old during their first visit. Bivariate correlations were calculated to determine associations among medical incidents during competitors’ first medical tent visit. Logistic regression analyses were performed to investigate the likelihood of medical incidents occurring in subsequent years following the initial occurrence. RESULTS: Significant associations were found between vomiting and nausea (r=0.493, p=0.01) as well as vomiting and diarrhea (r=0.319, p=0.05) for competitors’ first visit. Competitors diagnosed with hyponatremia during their first year were significantly more likely to return with the same medical problem in subsequent years compared to those who were not hyponatremic during the first visit (OR=5.714, 95% CI: 5.027-6.401). A similar trend was displayed for diarrhea (OR=3.647, 95% CI: 3.339-3.955). Contrarily, participants that experienced dizziness during their initial visit were less likely to return for the same problem in subsequent years (OR=0.722, 95% CI: 0.572-0.872). No differences were found for the likelihood of vomiting, nausea, and muscle cramps after initial occurrences. CONCLUSION: Initial occurrences of diarrhea and hyponatremia indicate increased likelihood of repeat occurrence in subsequent years. Analyses of additional adverse medical symptoms and diagnoses among repeat competitors and examinations of other age groups.

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