Haegeli Pascal, Falk Markus, Procter Emily, Zweifel Benjamin, Jarry Frédéric, Logan Spencer, Kronholm Kalle, Biskupič Marek, Brugger Hermann
Avisualanche Consulting, 2-250 E 15th Avenue, Vancouver, BC, V5T 2P9, Canada; School for Resource and Environmental Management, Simon Fraser University, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada.
Inova Q Inc., Tinkhauserstrasse 5b, 39031 Bruneck/Brunico, Italy.
Resuscitation. 2014 Sep;85(9):1197-203. doi: 10.1016/j.resuscitation.2014.05.025. Epub 2014 Jun 6.
Asphyxia is the primary cause of death among avalanche victims. Avalanche airbags can lower mortality by directly reducing grade of burial, the single most important factor for survival. This study aims to provide an updated perspective on the effectiveness of this safety device.
A retrospective analysis of avalanche accidents involving at least one airbag user between 1994 and 2012 in Austria, Canada, France, Norway, Slovakia, Switzerland and the United States. A multivariate analysis was used to calculate adjusted absolute risk reduction and estimate the effectiveness of airbags on grade of burial and mortality. A univariate analysis was used to examine causes of non-deployment.
Binomial linear regression models showed main effects for airbag use, avalanche size and injuries on critical burial, and for grade of burial, injuries and avalanche size on mortality. The adjusted risk of critical burial is 47% with non-inflated airbags and 20% with inflated airbags. The adjusted mortality is 44% for critically buried victims and 3% for non-critically buried victims. The adjusted absolute mortality reduction for inflated airbags is -11 percentage points (22% to 11%; 95% confidence interval: -4 to -18 percentage points) and adjusted risk ratio is 0.51 (95% confidence interval: 0.29 to 0.72). Overall non-inflation rate is 20%, 60% of which is attributed to deployment failure by the user.
Although the impact on survival is smaller than previously reported, these results confirm the effectiveness of airbags. Non-deployment remains the most considerable limitation to effectiveness. Development of standardized data collection protocols is encouraged to facilitate further research.
窒息是雪崩遇难者的主要死因。雪崩安全气囊可通过直接降低被掩埋程度来降低死亡率，而被掩埋程度是生存的唯一最重要因素。本研究旨在提供关于这种安全装置有效性的最新观点。
对1994年至2012年间在奥地利、加拿大、法国、挪威、斯洛伐克、瑞士和美国发生的涉及至少一名使用安全气囊者的雪崩事故进行回顾性分析。采用多变量分析来计算调整后的绝对风险降低率，并估计安全气囊对被掩埋程度和死亡率的有效性。采用单变量分析来检查安全气囊未展开的原因。
二项式线性回归模型显示，安全气囊的使用、雪崩规模和受伤情况对临界掩埋有主要影响，而被掩埋程度、受伤情况和雪崩规模对死亡率有主要影响。未充气安全气囊的临界掩埋调整风险为47%，充气安全气囊的临界掩埋调整风险为20%。临界掩埋受害者的调整死亡率为44%，非临界掩埋受害者的调整死亡率为3%。充气安全气囊的调整绝对死亡率降低为-11个百分点（从22%降至11%；95%置信区间：-4至-18个百分点），调整风险比为0.51（95%置信区间：0.29至0.72）。总体未充气率为20%，其中60%归因于使用者操作失误。
尽管对生存的影响比先前报道的要小，但这些结果证实了安全气囊的有效性。安全气囊未展开仍然是有效性方面最严重的限制因素。鼓励制定标准化的数据收集方案，以促进进一步研究。
