Stella-Watts Alejandro C, Holstege Christopher P, Lee Jae K, Charlton Nathan P
Department of Emergence Medicine, University of Rochester, Rochester, NY, USA.
Wilderness Environ Med. 2012 Sep;23(3):215-22. doi: 10.1016/j.wem.2012.03.004. Epub 2012 Jun 15.
Caving is a demanding sport practiced throughout the world. Currently, there are no collective data analyzing injury mechanism or type in these austere environments. This study is a retrospective analysis of caving incidents documented by the National Speleological Society (NSS)-American Caving Accidents (ACA) annual publication.
This study retrospectively analyzes 877 incident reports collected between 1980 and 2008 by NSS-ACA. For each victim, the month, year, location, age, gender, incident type, injury zone of the body, injury type, the result of the incident, and time intervals for rescue were extracted.
A total of 1356 victims were identified; 83% of victims were male, 17% were female. Ages ranged from 2 to 69 years old, with an average of 27 years. The greatest number of events occurred in summer months, peaking in July. The most common incident leading to traumatic injury was a caver fall (74%), also contributing to 30% of caver fatalities. Lower extremities were most commonly injured (29%), followed by the upper extremities and head (21% and 15%, respectively). Fractures comprised 41% of injuries, followed by lacerations (13%), bruise, hematoma, and abrasions (12%), and sprains and strains (7%).
The majority of injuries were not life threatening; however, over the course of 28 years there were 81 documented fatalities. Similar to other studies of wilderness injuries, fractures, soft tissue injuries, and lacerations were prominent in this study. In general, the overall precipitating event leading to injuries is falling, leading to orthopedic trauma. To better prepare cave rescue teams we have attempted to describe the characteristics of caving injuries in the United States.
洞穴探险是一项在全球开展的高要求运动。目前，尚无关于这些恶劣环境中损伤机制或类型的综合数据分析。本研究是对美国国家洞穴协会（NSS）-美国洞穴事故（ACA）年度出版物中记录的洞穴探险事故进行的回顾性分析。
本研究回顾性分析了NSS-ACA在1980年至2008年期间收集的877份事故报告。对于每位受害者，提取了月份、年份、地点、年龄、性别、事故类型、身体损伤部位、损伤类型、事故结果以及救援时间间隔。
共识别出1356名受害者；83%的受害者为男性，17%为女性。年龄范围为2至69岁，平均年龄为27岁。事故发生最多的月份是夏季，7月达到峰值。导致创伤性损伤的最常见事故是洞穴探险者坠落（74%），也是导致30%洞穴探险者死亡的原因。下肢最常受伤（29%），其次是上肢和头部（分别为21%和15%）。骨折占损伤的41%，其次是撕裂伤（13%）、瘀伤、血肿和擦伤（12%）以及扭伤和拉伤（7%）。
大多数损伤不危及生命；然而，在28年的时间里有81例记录在案的死亡病例。与其他荒野损伤研究类似，骨折、软组织损伤和撕裂伤在本研究中较为突出。一般来说，导致损伤的总体突发情况是坠落，从而导致骨科创伤。为了更好地为洞穴救援团队做好准备，我们试图描述美国洞穴探险损伤的特征。
