One member of the MAGMO team had to take charge and be responsible for medical issues in the stadium for each of the 45 matches. The MAGMO team was finally composed of 8 members: one tournament medical director (TMD), three original members, and 4 additional members appointed in April 2019. The Medical Advisory Group Medical Officers (MAGMO) team of the RWC 2019 OC was established in March 2017.
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reported that it was important to integrate the planning within the existing emergency medical care system, given that routine emergency care must continue. Several papers have reported that some factors predicted patient presentation rates (PPRs) at mass gathering events, and the most common patient presentations at mass gathering events were mild in severity. Moreover, there is the potential risk of alcohol-related problems at rugby events. Arbon reported that a mass gathering event is a situation during which a gathering of crowds produces limited access to patients thus, there is a potential for delayed response to a medical emergency. Medical services for spectators are key issues for mass gathering events. The definition of a mass gathering event has traditionally been a group of over 1000 attendees gathered at a specific location for a specific period. On the other hand, the medical service system for spectators depended on the RWC Organising Committee (OC). The medical support system in the field of play and the medical service for players and match officials are strictly managed and supervised by the World Rugby, including the required international medical licenses, such as “Immediate Care in Rugby” level 2 or 3 certified by the World Rugby or “Pre-Hospital Immediate Care in Sports” level 2 or 3 certified by the Rugby Football Union (England). The total number of spectators in the stadiums was 1,704,443 (with roughly 242,000 foreign spectators) the average number of spectators per match was 37,877 and the ticket sales rate was 99.3%. This competition was the very first event in the history of the RWC to be held in Asia. During these 44 days, a total of 45 international matches were played in 12 venues across Japan, but, unfortunately, 3 matches were canceled due to a typhoon disaster. The 9th RWC took place in Japan from September 20 to November 2, 2019. The Rugby World Cup (RWC) is one of the biggest international mega sports events in the world. Careful medical preparation, management, and development of public education programs for higher WBGT situations will be required in the future for similar international mega sports events. On the other hand, a higher WBGT situation contributes significantly to an increased PPR ( 25, 2.04 versus 4.27, p = 0.04). During RWC 2019, the majority (91.5%) of patients who sought medical attention did so for minor complaints, which were easily assessed and managed. Preparation and provision of appropriate medical service for spectators is a key factor for mass-gathering events. The incidence rate of cardiopulmonary arrest per 10,000 attendees was 0.0059 during RWC 2019. The most common reasons for transfer to the hospital were heat illness and fracture/dislocation, at a rate of 15.8% each. Thirty-eight cases were transferred to a hospital by ambulance the PPR was 0.22.
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The PPR was significantly higher for the matches held with a WBGT over 25 ☌ than for the matches under 21 ☌ (PPR 4.27 vs 2.04, p = 0.04). Most cases (91.5%) were mild in severity. The total number of visits to the spectator medical room was 449 with a PPR of 2.63. Mild cases were considered non-life threatening requiring minimal medical intervention, and severe cases required transport to a hospital. Severity categories were defined as mild or severe. The patient presentation rate (PPR) was calculated per 10,000 attendees.
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The wet bulb globe temperature (WBGT) value at the kick-off time of each match, the number of visits to the spectator medical room, and the number of transfers to a hospital were reviewed and analyzed. All patients in the stadium who visited the spectator medical room and were transferred to a hospital were included. This was a retrospective review of medical records from spectator medical rooms of 45 official matches of RWC 2019 between September 20 and November 2, 2019. This study was conducted to identify and evaluate the volume, nature, and severity of spectator medical care in the stadiums of 12 venues across Japan during RWC 2019.