The Impact of Mass Gatherings and Events on Emergency Department Admissions: A Systematic Literature Review
Ali PoshtMashhadi, Lincoln C. Wood, Abtin Ijadi Maghsoodi
Abstract
BACKGROUND: Mass gatherings, including major sporting events, music festivals, and other large gatherings, are integral to cultural and social life but can significantly impact local healthcare services. Understanding the effect of these events on emergency department (ED) admissions is crucial for effective resource planning and public health preparedness. OBJECTIVES: This systematic literature review (SLR) aims to investigate the influence of mass gatherings on ED admissions, focusing on the overall and category-specific ED metrics associated with these events. METHODS: Following PRISMA guidelines, we conducted a comprehensive database search spanning 2012-2024 using PubMed, EMBASE, Web of Science, ProQuest, Scopus, Springer, Cochrane Library, and Science Direct. We identified 14 relevant studies on mass gatherings and ED presentations from various countries. BERT natural language processing and manual screening were used to achieve over 90% efficiency in excluding irrelevant articles. RESULTS: Fourteen studies show ED visits vary during mass gatherings: some events see 7.5-37% drops, while others, especially music festivals and religious gatherings, reach spikes up to 83% (during Umrah). Substance-related cases rise (up to 10%), trauma accounts for up to 34%, and surges often occur 4-12 hours postevent. Music festivals feature more substance-related cases, while religious gatherings see higher medical and respiratory admissions. CONCLUSIONS: The findings indicate varying impacts on ED utilization during mass gatherings, with some events showing fewer overall visits and others reporting spikes, particularly in trauma and substance-related cases. The review highlights the need for postevent surge preparedness, advocating coordinated planning with organizers and targeted public health interventions.