A pilot case-control study of behavioral aspects and risk factors in Swiss climbers
TL;DR: Climbers with higher experience seem to be more prone to injuries, and larger studies on this subgroup are warranted, to identify typical risk profiles and to develop preventive strategies.
Abstract: BACKGROUND: Climbing is a popular sport in Switzerland, with approximately 100 000 active participants. There is an inherent risk of falls, overuse and stress-related trauma, with a reported injury rate of 4.2 injuries per 1000 climbing hours. OBJECTIVE: Comparison of possible risk factors in patients and noninjured controls. METHODS: A case-control survey was conducted. Climbers admitted to three trauma units between June and October 2008 were surveyed using a questionnaire evaluating nine potential risk factors. The same questionnaire was distributed to noninjured climbers during the same time period. Logistic regression was performed. RESULTS: Fifty patients and 63 controls were included in this survey. Variables significant for patients were: more than 10 years versus less than 1 year of climbing experience (odds ratio: 5.34; confidence interval: 1.16-17.76; P=0.006) and no previous experiences of the climbing route (odds ratio: 2.72; confidence interval: 1.15-6.39; P=0.022). No statistical significance was detected for age, sex, difficulty level of the climbing route, warm-up, readiness for risk and abstinence from alcohol and drugs. CONCLUSION: Climbers with higher experience seem to be more prone to injuries. Larger studies on this subgroup are warranted, to identify typical risk profiles and to develop preventive strategies. Furthermore, climbers should be advised about the increased injury risk when trying new climbing routes and specific information should be given. Language: en
Summary (2 min read)
- What started as a traditional form of adventure has nowadays grown into a popular recreational and competitive activity, spreading rapidly across the globe.
- The number of climbers, in general, is estimated to be much higher, given the size of the US country and opportunities for climbing there.
- In Switzerland, approximately 100 000 people regularly climb as a recreational sport (unpublished data, Swiss Alpine Club, 2010).
- Therefore, compared with other recreational activities, climbing sports have a lower injury incidence and severity score than many popular sports, including basketball, sailing, or soccer .
- Three emergency departments (EDs), one level I trauma centre and two regional hospitals.
- Unauthorized reproduction of this article is prohibited.
- All patients acutely injured from indoor or outdoor climbing and admitted to one of the three EDs between 1 June and 31 October 2008 were included.
- Patients with chronic overuse syndromes, intracranial bleeding, skull fractures, Glasgow Coma Score (GCS) of greater than 14 or persistent retrograde amnesia were excluded.
- Patients were interviewed after the injury at one of the three EDs, or, in cases that did not allow time for interview in the ED, during their hospital stay.
- A questionnaire incorporating nine potential risk factors was used.
- Noninjured climbers were prospectively interviewed during the same time period at different popular climbing spots, using the same questionnaire.
- Participation in the study was voluntary and anonymous; confidentiality was granted.
- Data were collected, stored, analyzed and shared according to the ethical committee standards of the three hospitals.
- To identify study groups based on various predictors, univariate logistic regression analysis was performed.
- Odds ratios (OR) with corresponding 95% confidence intervals (95% CI) were reported.
- For ordinal or metric variables, ORs were expressed as the ratio of the odds increasing the predictor one unit.
- All evaluations were calculated with R version 2.7.0 .
- Fifty patients and 63 controls were interviewed.
- Details are described in Fig. 2. Logistic regression analysis shown in Table 1 demonstrated that the following variables were significant for patients: more than 10 years of climbing experience (vs. < 1 year of climbing experience), and no previous experiences of the climbing route.
- Crude numbers of risk factor variables are described in Table 2.
- Reports on risk factors in climbing are rare and to the best of their knowledge, there have been no case–control studies on risk factors in climbing injuries, other than Copyright © Lippincott Williams & Wilkins.
- Unauthorized reproduction of this article is prohibited.
- One explanation for this could be that dedicated climbers participate in different forms of climbing more often and therefore increase their cumulative injury risk .
- After sustaining an accident, the reported readiness to take risk might be overestimated or underestimated.
- Warm-up before climbing did not emerge as a protective factor in their analysis.
- To minimize sources of bias, patients with severe head or life-threatening injuries were excluded.
- The results that emerged as statistically significant did so only when seen as isolated factors and not in the context of the distribution of all other factors in the patient and control groups.
- The authors study is limited in numbers of participants and represents a pilot project for understanding risk factors in climbing.
- Patients with moderate-to-severe brain injury were excluded, 18 patients suffered from mild head trauma or injury to the face.
- The question on readiness for risk has been answered by self-estimation, which can cause recall and information bias.
- Climbers with higher experience seem to be more prone to injuries and therefore larger studies on this subgroup are warranted to show typical risk profiles and to develop preventive strategies.
- Not the level of difficulty of the route, but missing route experience seems to put climbers at risk.
- Hence, advice about the increased injury risk when trying new climbing routes and specific information about the route should be given in advance.
- In addition, physical, mental and technical preparations of climbers, as well as the role of the rope partner need further investigation.
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Cites background or result from "A pilot case-control study of behav..."
...…as they do not address the described risk factors of CRI (e.g., overweight, climbing level, climbing experience, climbing frequency, and the climbing type; Josephsen et al., 2007; Jones et al., 2008; Backe et al., 2009; van Middelkoop et al., 2011; Hasler et al., 2012; Woollings et al., 2015)....
...However, our results confirm previous observations showing that these traditional preventive measures are not associated with, or are not effective enough to prevent climbing injuries (Josephsen et al., 2007; van Middelkoop et al., 2011; Hasler et al., 2012; Woollings et al., 2015)....
Cites background from "A pilot case-control study of behav..."
...Most of the articles are retrospective or describe the prevalence of climbers who received medical treatment [2,32]....
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