• Ahmed H Alquthami and Jesse M Pines.
• 1 Department of Health Services Administration and Leadership, George Washington University, Washington, DC USA and Civil Defense Aviation, Mekkah Province, Kingdom of Saudi Arabia.
• Prehosp Disaster Med. 2014 Apr 1;29(2):167-75.

IntroductionThe review was conducted to evaluate if the field of mass-gathering medicine has evolved in addressing: (1) the lack of uniform standard measures; (2) the effectiveness of and needs for various interventions during a mass gathering; and (3) the various types of noncommunicable health issues (trauma and medical complaints) encountered and their severity during a gathering.MethodsA systematic review of papers published from 2003 through 2012 was conducted using databases of MEDLINE, Ovid, CINHAL, EBSCOHost, National Library of Medicine (NLM), Agency for Healthcare Research and Quality (AHRQ), Elsevier, Scopus, and Proquest databases. Of 37,762 articles, 17 articles were included in this review, covering 18 mass-gathering events; 14 were multiple-day events.ResultsAcross all events, the patient presentation rate (PPR) ranged from 0.13 to 20.8 patients per 1,000 attendees and the transfer to hospital rate (TTHR) ranged from 0.01 to 10.2 ambulance transports per 1,000 attendees. In four out of the seven studies, having on-site providers was associated with a lower rate of ambulance transports. The highest frequencies of noncommunicable presentations were headaches, abdominal complaints, and abrasions/lacerations. Most presentations were minor. Emergent cases requiring hospitalization (such as acute myocardial infarction) were rare.ConclusionsThe rate of noncommunicable health issues varies across events and very serious emergencies are rare.

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