Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy.
Department of Anesthesia and Intensive Care Medicine, Hospital of Merano, Merano, Italy.
JAMA Netw Open. 2024 Sep 3;7(9):e2435253. doi: 10.1001/jamanetworkopen.2024.35253.
Survival probability among individuals critically buried by avalanche is highly time dependent, which was demonstrated 30 years ago. However, it remains unclear whether avalanche survival probability has changed over time.
To assess the avalanche survival rate and probability as well as the rescue probability over the past 4 decades.
DESIGN, SETTING, AND PARTICIPANTS: In this cohort study, avalanche data from Switzerland that were collected by the WSL Institute for Snow and Avalanche Research (SLF) in Davos were analyzed from the winter beginning in 1981 to that beginning in 2020 and compared with data from the period 1981 to 1990. Data were analyzed from January to April 2024.
Critical avalanche burial (ie, burial involving the head and chest).
Survival rate among individuals critically buried by avalanche, survival probability, and rescue probability in relation to time buried under the avalanche.
The study included 1643 individuals critically buried by avalanche (mean [SD] age, 37 [13.7] years; 1090 of 1342 with known sex [81.2%] were male) among 3805 avalanches involving 7059 persons. Compared with the period from 1981 to 1990, the total survival rate over the full study period increased from 43.5% (95% CI, 38.8%-48.3%) to 53.4% (95% CI, 51.0%-55.8%). Survival probability remained high at 91% (95% CI, 80%-100%) for rescue during the first 10 minutes but then decreased to 31% (95% CI, 11%-51%) for rescue between 10 and 30 minutes. The survival rate among those buried long term (>130 minutes) increased from 2.6% (95% CI, 0.7%-6.9%) to 7.3% (95% CI, 4.8%-10.7%). The median rescue time decreased from 45 (IQR, 15-148) minutes to 25 (IQR, 10-85) minutes. Survival rates among individuals rescued from avalanche by organized rescue teams increased from 14.0% (28 of 200) to 22.9% (161 of 704).
This cohort study of 1643 individuals critically buried by avalanche found that over the past 4 decades, total survival rates considerably increased and rescue times decreased. Survival rates among those buried long term (>130 minutes) also increased. These findings are likely attributable to collaborative efforts among stakeholders to enhance avalanche search-and-rescue techniques and medical interventions.
30 年前的研究表明，被雪崩严重掩埋的个体的存活概率高度依赖于时间。然而，目前尚不清楚雪崩的存活概率是否随时间发生了变化。
评估过去 4 个十年间的雪崩存活率和概率以及救援概率。
设计、地点和参与者：本队列研究分析了 1981 年至 2020 年冬季瑞士 WSL 雪崩研究所（SLF）收集的雪崩数据，并与 1981 年至 1990 年的数据进行了比较。数据于 2024 年 1 月进行分析。
严重雪崩掩埋（即涉及头部和胸部的掩埋）。
被雪崩严重掩埋的个体的存活率、生存概率以及与雪崩掩埋时间有关的救援概率。
这项研究纳入了 3805 次雪崩事件中的 1643 名被严重掩埋的个体（平均[SD]年龄为 37[13.7]岁；1342 名已知性别的个体中有 1090 名[81.2%]为男性），涉及 7059 人。与 1981 年至 1990 年期间相比，整个研究期间的总存活率从 43.5%（95%CI，38.8%-48.3%）增加到 53.4%（95%CI，51.0%-55.8%）。在最初的 10 分钟内进行救援时，救援的生存概率保持在 91%（95%CI，80%-100%）的高位，但在 10 至 30 分钟之间进行救援时，其概率降至 31%（95%CI，11%-51%）。在长期（>130 分钟）掩埋的个体中，存活率从 2.6%（95%CI，0.7%-6.9%）增加到 7.3%（95%CI，4.8%-10.7%）。中位数救援时间从 45（IQR，15-148）分钟缩短至 25（IQR，10-85）分钟。从雪崩中被有组织的救援队伍救出的个体的存活率从 14.0%（28 名/200 名）增加到 22.9%（161 名/704 名）。
这项对 1643 名被雪崩严重掩埋的个体的队列研究发现，在过去的 40 年中，总存活率显著提高，救援时间缩短。长期（>130 分钟）掩埋的个体的存活率也有所增加。这些发现可能归因于利益相关者之间的合作努力，以提高雪崩搜索和救援技术以及医疗干预措施。
