Wasden Chad C, McIntosh Scott E, Keith David S, McCowan Christy
Department of Emergency Medicine, University of Utah, Salt Lake City, Utah 84132, USA.
J Trauma. 2009 Nov;67(5):1022-6. doi: 10.1097/TA.0b013e3181b0d559.
Injuries sustained while skiing or snowboarding are commonly encountered in emergency departments near winter resorts. The purpose of this study is to identify and compare the types of injuries likely to be found in the skier or snowboarder patient. An additional goal of this study is to provide a description of the demographics and hospitalizations for these patients.
A retrospective cohort study consisting of patients treated for skiing- or snowboarding-related injuries was performed at the University of Utah Medical center. All emergency department visits were captured: walk-ins and emergency medical service transports (ground and air). Seven hundred ninety-four skiing and 348 snowboarding-related cases were identified for a total of 1,142. Cases that occurred within 2001/2002 to 2005/2006 seasons were included in the study. Injuries were classified according to the International Classification of Diseases-9th Revision system and categorized by body location and specific type of injury. Outputs for this study include the chi test using the skiers as the control group due to size, with risk odds ratios comparing snowboarders to skiers. A p value of <0.05 was considered significant.
Patients injured while skiing and snowboarding were predominantly men, representing 70.0% of injured skiers and 87.6% of injured snowboarders. The mean age for skiers was 41 (SD = 16), whereas the mean age for snowboarders was 23 (SD = 8). High percentages of patients among both groups had suffered injury to the head, which was more common in snowboarders when compared with skiers (27.3% vs. 20.4%, p = 0.010). Despite this fact, skiers tended to have slightly higher percentages of Glasgow Coma Scores in the moderate to severe range and accounted for all fatalities secondary to head injury (8 of 9 fatalities). The single snowboarder fatality was not caused by head injury but rather pneumothorax. Injuries to the head that were more common in skiers were fractures to the facial bones (5.2% vs. 1.4%, p = 0.003) and facial lacerations (5.8% vs. 2.9%, p = 0.035). Skiers were more likely to sustain injuries to the lower extremities (51.3% vs. 26.2%, p < 0.001), whereas snowboarders commonly had injuries to the abdomen and its organs (22.4% vs. 11.2%, p < 0.001). A considerable amount of snowboarders had injuries to the spleen (11.2%), liver (3.7%), and kidney (2.2%). Injuries to the spine were common in both groups but more in snowboarders (20.7% vs. 13.4%, p = 0.002). On an average, skiers spent 3.4 days in the hospital (SD = 3), a day longer than snowboarders who averaged 2.4 (SD = 2). Skiers were more frequently admitted to the floor or the operating room, whereas snowboarders were more often admitted to the intensive care unit.
Patients injured while skiing or snowboarding are predominantly men, and participants in both sports are at risk for sustaining major injuries. The types of injuries differ and are dependent on the sport. An awareness of these differences will help skiers and snowboarders minimize their risk of injury by altering their riding strategies and by choosing appropriate protective equipment.
在冬季度假胜地附近的急诊科，滑雪或单板滑雪时受的伤很常见。本研究的目的是识别和比较滑雪者或单板滑雪者可能出现的损伤类型。本研究的另一个目标是描述这些患者的人口统计学特征和住院情况。
在犹他大学医学中心进行了一项回顾性队列研究，研究对象为因滑雪或单板滑雪相关损伤接受治疗的患者。记录了所有急诊科就诊情况：自行前来就诊者以及紧急医疗服务转运患者（地面和空中转运）。共识别出794例滑雪相关病例和348例单板滑雪相关病例，总计1142例。纳入研究的病例发生在2001/2002至2005/2006赛季。损伤根据国际疾病分类第九版系统进行分类，并按身体部位和损伤的具体类型进行归类。本研究的结果包括以滑雪者为对照组进行的卡方检验（因样本量原因），以及比较单板滑雪者与滑雪者的风险比值比。p值<0.05被认为具有统计学意义。
滑雪和单板滑雪受伤的患者以男性为主，占受伤滑雪者的70.0%，受伤单板滑雪者的87.6%。滑雪者的平均年龄为41岁（标准差=16），而单板滑雪者的平均年龄为23岁（标准差=8）。两组中很大比例的患者头部受伤，与滑雪者相比，单板滑雪者头部受伤更为常见（27.3%对20.4%，p = 0.010）。尽管如此，滑雪者中度至重度格拉斯哥昏迷评分的比例略高，且头部受伤导致的所有死亡病例（9例死亡中的8例）均为滑雪者。唯一的单板滑雪者死亡不是由头部受伤引起的，而是气胸。滑雪者中更常见的头部损伤是面部骨骼骨折（5.2%对1.4%，p = 0.003）和面部撕裂伤（5.8%对2.9%，p = 0.035）。滑雪者下肢受伤的可能性更大（51.3%对26.2%，p < 0.001），而单板滑雪者腹部及其器官受伤较为常见（22.4%对11.2%，p < 0.001）。相当数量的单板滑雪者脾脏（11.2%）、肝脏（3.7%）和肾脏（2.2%）受伤。脊柱损伤在两组中都很常见，但单板滑雪者更多见（20.7%对13.4%，p = 0.002）。滑雪者平均住院3.4天（标准差=3），比单板滑雪者平均多一天，单板滑雪者平均住院2.4天（标准差=2）。滑雪者更频繁地被收治到普通病房或手术室，而单板滑雪者更常被收治到重症监护病房。
滑雪或单板滑雪受伤的患者以男性为主，两项运动的参与者都有遭受重伤的风险。损伤类型不同，且取决于运动项目。了解这些差异将有助于滑雪者和单板滑雪者通过改变骑行策略和选择合适的防护装备来降低受伤风险。
