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Major trauma in winter sports: an international trauma database analysis

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Abstract

Purpose

The aim of this study was to compare the demographics, injury patterns, and outcomes following major trauma between Alpine skiing, snowboarding, and sledding winter sports.

Methods

An international population-based prospective trauma database (TraumaRegister DGU®) was analyzed for demographic data, types and severity of injuries [body regions, Injury Severity Score (ISS)], early physiology [Glasgow Coma Scale (GCS), blood pressure, body temperature], rescue modality, surgical care, length of stay, and major complications (shock, multiple organ failure mortality). Participating countries included Germany, Austria, Switzerland, Finland, Slovenia, Belgium, Luxembourg, and The Netherlands.

Results

A total of 243 winter sport athletes with major trauma were identified (1993–2012), and subjects were divided into Alpine skiers (n = 174), snowboarders (n = 29), and sledders (n = 40). Athletes were predominantly male and presented hypothermic at emergency room arrival, despite a large proportion of air rescue (77 %). Alpine skiing was associated with higher injury severity (ISS 20.8 ± 14.0, p = 0.010) when compared with snowboarding (ISS 18.7 ± 14.0) and sledding (ISS 13.8 ± 9.5). Snowboarding was associated with the highest pre-hospital intubation rate (40.9 %, p = 0.007), despite comparable GCS values and prevalence of loss of consciousness at scene. The injury patterns were different between the three groups. Skiing was associated with head (47.1 %), chest (40.2 %, p = 0.047), and spinal injuries (40.9 %, p = 0.022). Snowboarding was associated with the highest percentage of upper extremity trauma. Sledders had the highest prevalence of facial and lower extremity trauma.

Conclusions

Alpine skiing, snowboarding, and sledding result in different injury patterns and affect various age groups. Our data suggest an increased risk for chest and spinal injuries in Alpine skiers. Due to high-energy injury mechanisms, all three winter sports involve a risk of severe multiple trauma. While all athlete groups required a high rate of emergency surgery procedures, the observed in-hospital mortality from winter sports remains low.

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Acknowledgments

The paper has been nominated for the Best Poster/Bullit-Price at the 16th European Congress of Trauma and Emergency Surgery in Amsterdam, The Netherlands.

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Authors and Affiliations

  1. Department of Orthopaedics and Trauma Surgery, RWTH Aachen University Medical Center, Pauwels Street 30, 52074, Aachen, Germany

    C. D. Weber, K. Horst, M. Hofman, T. Dienstknecht & H.-C. Pape

  2. Olympic Center Rhineland, Aachen, Germany

    C. D. Weber & M. Hofman

  3. Committee on Emergency Medicine, Intensive Care and Trauma Management of the German Trauma Society (Sektion NIS), Berlin, Germany

    R. Lefering

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  1. C. D. Weber
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  2. K. Horst
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  3. R. Lefering
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  6. H.-C. Pape
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TraumaRegister DGU

Corresponding author

Correspondence to C. D. Weber.

Ethics declarations

The present study follows the publication guidelines of the TraumaRegister DGU® and is registered as TR-DGU project ID 2013-050. In accordance with the institutional guidelines, informed consent was not required, because the documentation and data analysis within the trauma registry is mandatory for certified trauma centers to perform external quality assessment.

Conflict of interest

Christian Weber, Klemens Horst, Rolf Lefering, Martijn Hofman, Thomas Dienstknecht, and Hans-Christoph Pape declare that they have no conflict of interest. This study was performed without any financial or other support.

Funding statement

The TraumaRegister DGU® was previously partly funded by the Deutsche Forschungsgemeinschaft (Ne 385/5) and by a grant from Novo Nordisk A/S, Bagsvaerd, Denmark. It is now supported by fees from the participating hospitals (a list of hospitals is available at http://www.traumaregister.de) and hosted by the AUC—Academy for Trauma Surgery (AUC).

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Weber, C.D., Horst, K., Lefering, R. et al. Major trauma in winter sports: an international trauma database analysis. Eur J Trauma Emerg Surg 42, 741–747 (2016). https://doi.org/10.1007/s00068-015-0596-7

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  • DOI: https://doi.org/10.1007/s00068-015-0596-7

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