Let It Snow: How Snowfall and Injury Mechanism Affect Ski and Snowboard Injuries in Vail, Colorado, 2011–2012
There were more than 50 million skiing and snowboarding injuries during the 2011 winter season; however, there remains a lack of data correlating injury severity with environmental factors and mechanism of injury. The purpose of this study was to investigate correlations between injury severity, injury mechanism, and daily snowfall among skiers and snowboarders. The investigation was a single center, retrospective, observational study performed at Vail Valley Medical Center, a level III trauma facility. Inclusion criteria consisted of trauma patients who were either admitted, died, or were transferred to outside facilities during the 2011 and 2012 ski seasons. Injury severity was graded by 2 established medical scoring systems—the Injury Severity Score and the Abbreviated Injury Scale—that correlate with morbidity, mortality, and hospitalization time after trauma.
A total of 644 patients met inclusion criteria with the following demographics: average age 39 years, 66% male, and 67% skiers. The most common injury was to extremities, with upper extremities and lower extremities representing, respectively 39% and 33% of total injuries. Other injuries listed in decreasing prevalence included injuries to the thorax, head, abdomen, pelvis, and spine. Overall, 88% of patients sustained mild injuries, and the highest Abbreviated Injury Scale scores were for injuries to the axial skeleton, abdomen, and lower extremities. Sixty-five percent of the injuries occurred when there was less than 1 inch of snow in the previous 24 hours. Finally, the investigators found that whereas collisions only represented 15% of the injuries, they were associated with a significantly increased Injury Severity Score and higher rate of serious thoracic injuries including rib fractures, pneumothoraces, and hemothoraces.
The investigators conclude that this study helped to raise the index of suspicion for possible significant injuries of patients involved in collision accidents or with injuries to the axial skeleton, abdomen, and lower extremities. Additionally, the study suggested that increasing amounts of fresh snowfall provides a protective effect against severe injury. Limitations of the study include the use of a single medical facility, potentially incomplete medical records, and limitations of the injury scoring systems.
(J Trauma Acute Care Surg. 2013:75;334-338). SJ Moore, D Knerl.
Prepared by Matthew Stewart, MD, University of Utah Emergency Medicine Resident, Salt Lake City, UT, USA