University of Massachusetts Medical School, Department of Surgery, Division of Pediatric Surgery, 55 Lake Ave N, Worcester, MA 01655, United States.
Am J Emerg Med. 2019 Mar;37(3):439-443. doi: 10.1016/j.ajem.2018.06.006. Epub 2018 Jun 2.
In 2015, approximately 13,436 snowboarding or skiing injuries occurred in children younger than 15. We describe injury patterns of pediatric snow sport participants based on age, activity at the time of injury, and use of protective equipment.
A retrospective analysis was performed of 10-17 year old patients with snow-sport related injuries at a Level-1 trauma center from 2005 to 2015. Participants were divided into groups, 10-13 (middle-school, MS) and 14-17 years (high-school, HS) and compared using chi-square, Student's t-tests, and multivariable logistic regression.
We identified 235 patients. The HS group had a higher proportion of females than MS (17.5% vs. 7.4%, p = 0.03) but groups were otherwise similar. Helmet use was significantly lower in the HS group (51.6% vs. 76.5%, p < 0.01). MS students were more likely to suffer any head injury (aOR 4.66, 95% CI: 1.70-12.8), closed head injury (aOR 3.69 95% CI: 1.37-9.99), or loss of consciousness (aOR 5.56 95% CI 1.76-17.6) after 4 pm. HS students engaging in jumps or tricks had 2.79 times the risk of any head injury (aOR 2.79 95% CI: 1.18-6.57) compared to peers that did not. HS students had increased risk of solid organ injury when helmeted (aOR 4.86 95% CI: 1.30-18.2).
Injured high-school snow sports participants were less likely to wear helmets and more likely to have solid organ injuries when helmeted than middle-schoolers. Additionally, high-schoolers with head injuries were more like to sustain these injures while engaging in jumps or tricks. Injury prevention in this vulnerable population deserves further study.
Level III (Retrospective Comparative Study).
2015 年，15 岁以下儿童中约有 13436 例滑雪或单板滑雪受伤。我们根据年龄、受伤时的活动和使用防护设备的情况，描述了儿童参与雪地运动者的受伤模式。
对 2005 年至 2015 年在一家 1 级创伤中心因雪地运动相关受伤的 10-17 岁患者进行了回顾性分析。将参与者分为 10-13 岁（中学组，MS）和 14-17 岁（高中组，HS）两组，并使用卡方检验、学生 t 检验和多变量逻辑回归进行比较。
共纳入 235 例患者。与 MS 组相比，HS 组女性比例更高（17.5%比 7.4%，p=0.03），但两组其他方面相似。HS 组头盔使用率明显较低（51.6%比 76.5%，p<0.01）。MS 学生更可能遭受任何头部损伤（aOR 4.66，95%CI：1.70-12.8）、闭合性头部损伤（aOR 3.69，95%CI：1.37-9.99）或意识丧失（aOR 5.56，95%CI：1.76-17.6），尤其是在下午 4 点以后。与不从事跳跃或技巧的同龄人相比，从事跳跃或技巧的 HS 学生头部受伤的风险增加 2.79 倍（aOR 2.79，95%CI：1.18-6.57）。HS 学生戴头盔时发生实体器官损伤的风险增加（aOR 4.86，95%CI：1.30-18.2）。
与中学生相比，受伤的高中生雪地运动参与者戴头盔的可能性较低，而发生实体器官损伤的可能性较高。此外，头部受伤的高中生更有可能在从事跳跃或技巧时发生这些损伤。有必要对这一脆弱人群进行进一步的伤害预防研究。
三级（回顾性比较研究）。
