Helmet use is associated with higher Injury Severity Scores in alpine skiers and snowboarders evaluated at a Level I trauma center
| Autor: | Andrea B. Wolffing, James C Cooros, Eleah D. Porter, Madeleine G Haff, Kurt K Rhynhart, Andrew O. Crockett, Spencer W. Trooboff, Alexandra Briggs |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Poison control Critical Care and Intensive Care Medicine Suicide prevention Occupational safety and health Neck Injuries 03 medical and health sciences Young Adult 0302 clinical medicine Injury Severity Score Trauma Centers Skiing Injury prevention Medicine Craniocerebral Trauma Humans Child Aged Retrospective Studies Aged 80 and over business.industry Trauma center technology industry and agriculture Human factors and ergonomics 030208 emergency & critical care medicine Middle Aged equipment and supplies Traumatic injury Spinal Injuries Child Preschool Physical therapy Surgery Female Head Protective Devices business human activities Intracranial Hemorrhages |
| Zdroj: | The journal of trauma and acute care surgery. 87(5) |
| ISSN: | 2163-0763 |
| Popis: | There is uncertainty regarding the efficacy of ski helmets in preventing traumatic injury. We investigated the relationship between helmet use, injury types, and injury severity among skiers and snowboarders.The trauma registry at a Northeast American College of Surgeons Level I trauma center was queried by International Classification of Diseases Codes-9th or 10th Revision for skiing and snowboarding injury between 2010 and 2018. The primary exposure was helmet use and primary outcome was severe injury (Injury Severity Score15). We performed univariate and multivariable logistic regression to assess for injury types and severity associated with helmet use.Seven hundred twenty-one patients (65% helmeted, 35% unhelmeted) met inclusion criteria. Helmet use doubled during the study period (43% to 81%, p0.001), but the rate of any head injury did not significantly change (49% to 43%, p = 0.499). On multivariable regression, helmeted patients were significantly more likely to suffer severe injury (odds ratio [OR], 2.01; 95% confidence interval [CI], 1.30-3.11), intracranial hemorrhage (OR, 1.81; 95% CI, 1.10-2.96), chest injury (OR, 1.66; 95% CI, 1.05-2.61), and/or lumbosacral spine injury (OR, 1.84; 95% CI, 1.04-3.25) than unhelmeted patients. Helmeted patients were half as likely to suffer cervical spine injury (OR, 0.51; 95% CI, 0.30-0.89) and a third as likely to sustain skull fracture and/or scalp laceration (OR, 0.30; 95% CI, 0.14-0.64). More patients who hit a stationary object were helmeted compared with those who fell from standing height onto snow (70% vs. 56% respectively, p0.001). After adjustment, hitting a stationary object was the injury mechanism most significantly associated with severe injury (OR, 2.80; 95% CI, 1.79-4.38).Helmeted skiers and snowboarders evaluated at a Level I trauma center were more likely to suffer severe injury, including intracranial hemorrhage, as compared with unhelmeted participants. However, they were less likely to sustain skull fractures or cervical spine injuries. Helmeted patients were also more likely to hit a stationary object. Our findings reinforce the importance of safe skiing practices and trauma evaluation after high-impact injury, regardless of helmet use.Prognostic and epidemiological, level IV. |
| Databáze: | OpenAIRE |
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