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Journal ArticleDOI

Retrospective analysis of 616 air-rescue trauma cases related to the practice of extreme sports.

TL;DR: High-risk ESs led to high-energy accidents, characterized by a large proportion of severe injuries and axial traumas (spine, thorax, pelvis and proximal femur), which implied longer and more complex interventions.
Abstract: Introduction Extreme sports (ESs) are increasingly popular, and accidents due to ESs sometimes require helicopter emergency medical services (HEMSs). Little is known about their epidemiology, severity, specific injuries and required rescue operations. Aim Our aims were to perform an epidemiological analysis, to identify specific injuries and to describe the characteristic of prehospital procedures in ES accidents requiring HEMSs. Methods This is a retrospective study, reviewing all rescue missions dedicated to ESs provided by HEMS REGA Lausanne, from 1 January 1998 to 31 December 2008. ES were classified into three categories of practice, according to the type of risk at the time of the fall. Results Among the 616 cases meeting inclusion criteria, 219 (36%) were clearly high-risk ES accidents; 69 (11%) and 328 (53%) were related to potential ES, but with respectively low or indeterminate risk at the time of the fall. In the high-risk ES group, the median age was 32 years and 80% were male. Mortality at 48 h was 11%, almost ten times higher than in the other two groups. The proportion of potentially life-threatening injuries (the National Advisory Committee for Aeronautics (NACA) score ≥ 4) was 39% in the high-risk ES group and 13% in the other two groups. Thirty per cent of the cases in the high-risk ES group presented an Injury Severity Score (ISS) >15, compared with 7% in the other groups. Thoracolumbar vertebral fractures were the most common injuries with 32% of all cases having at least one, involving the T12–L2 junction in 56% of cases. The other most frequent injuries were traumatic brain injuries (16%), rib fractures (9%), pneumothorax (8%) and femoral (7%), cervical (7%), ankle (5%) and pelvic (5%) fractures. Median time on site for rescue teams was higher in the confirmed high-risk ES group, with 50% of prehospital missions including at least one environmental difficulty. Conclusions High-risk ESs led to high-energy accidents, characterized by a large proportion of severe injuries and axial traumas (spine, thorax, pelvis and proximal femur). We identified a considerable percentage of thoracolumbar vertebral fractures, mainly in the T12–L2 junction. HEMSs dedicated to high-risk ESs implied longer and more complex interventions.
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TL;DR: In the same way, as society has been experiencing significant changes in recent years, sport practice has evolved to acquire extraordinary importance, both socially and economically as mentioned in this paper, both in terms of social and economic.
Abstract: In the same way, as society has been experiencing significant changes in recent years, sport practice has evolved to acquire extraordinary importance, both socially and economically. At the...

23 citations

Journal ArticleDOI
TL;DR: Trauma incidents in mountainous areas commonly feature significantly increased out‐of‐hospital time which is associated with a more severe ISS, higher risk of accidental hypothermia and more frequent hypotension compared to urban/suburban trauma.
Abstract: Objective We investigated pre-hospital times, clinical characteristics and therapeutic interventions in multisystem trauma patients injured in mountainous areas in comparison to both urban and suburban trauma patient admissions. Methods Pre-hospital and in-hospital data collected from trauma patients included in the International Alpine Trauma Register (IATR) hosted in Bolzano, Italy (aged 16–80 yr with an ISS ≥ 16), were compared with trauma patient data published from those urban and suburban areas included in the Trauma Register DGU® (TR-DGU) of the German Trauma Society. Results A total of 94 patients from the IATR and 11,020 patients from the TR-DGU met the inclusion criteria. Due to longer treatment-free intervals (mean 59.1 vs. 19.7 min), total out-of-hospital time was reportedly longer in individuals injured in mountainous areas, compared to urban/suburban areas (117.4 ± 142.9 vs. 68.7 ± 28.6 min, p = 0.002), despite the more frequent helicopter rescue (93% vs. 40%, p Conclusion Trauma incidents in mountainous areas commonly feature significantly increased out-of-hospital time which is associated with a more severe ISS, higher risk of accidental hypothermia and more frequent hypotension compared to urban/suburban trauma. Nonetheless, the mortality rate of IATR patients is comparable to urban/suburban trauma patients.

17 citations


Cites background from "Retrospective analysis of 616 air-r..."

  • ...In parallel, the number of rescue missions in mountainous environments has reportedly increased [2], plus the proportion of potentially life threatening injuries incurred has notably risen [3]....

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Journal ArticleDOI
TL;DR: The death rate from sport and active recreation decreased over the course of 10 years in Victoria, while the rate of nonfatal major trauma almost doubled, highlighting the need to prioritize investments in the prevention of trauma in these activities.
Abstract: Background:Sports injuries that result in major trauma or death are associated with significant health care burden and societal costs. An understanding of changes in injury trends, and their driver...

14 citations

Journal ArticleDOI
TL;DR: This multicenter study evaluated sport-specific injury patterns and mechanisms, to characterize individuals at risk and to identify possible approaches for prevention, to predominantly affect young male athletes.
Abstract: The participation in extreme and contact sports has grown internationally, despite the significant risk for major and multiple injuries. We conducted this multicenter study to evaluate sport-specific injury patterns and mechanisms, to characterize individuals at risk and to identify possible approaches for prevention. We compared demographic data, severity and patterns of injuries; and the pre- and in-hospital management from an international population-based prospective trauma database (TraumaRegister DGU®). The registry was screened for sport-related injuries, and only patients with major injuries [Injury Severity Score (ISS) ≥ 9 points] related to extreme or contact sports activities were included (January 1, 2002, to December 31, 2012). Parameters were compared for different types of sports activities: (1) Airborne sports, (2) Climbing, (3) Skateboarding/Skating, (4) Contact sports. The following countries participated: Germany, Austria, Switzerland, Finland, Slovenia, Belgium, Luxembourg, and The Netherlands. Statistical analyses were performed with SPSS (Version 22, IBM Inc., Armonk, New York). A total of 278 athletes were identified within the study period and classified into four groups: Airborne sports (n = 105) were associated with the highest injury severity (ISS 22.4 ± 14.6), followed by climbing (n = 35, ISS 16.5 ± 12), skating (n = 67, ISS 15.2 ± 10.3) and contact sports (n = 71, ISS 10.4 ± 9.2). Especially high falls resulted in a significant rate of spinal injuries in airborne activities (68.6%, p < 0.001) and in climbing accidents (45.7%). Skating was associated with the highest rate of loss of consciousness (LOC) at scene (27.1%), the highest pre-hospital intubation rate (33.3%), and also the highest in-hospital mortality (15.2%, p < 0.001), related to major head injuries. Extreme and contact sports related major injuries predominantly affect young male athletes. Especially skaters are at risk for debilitating and lethal head injuries. Individuals recognizing sport-specific hazards might modify their risk behavior. Descriptive Epidemiologic Study, Level II.

11 citations

Journal ArticleDOI
TL;DR: Freeriding might provide beneficial transfer effects as shown through a higher agency transfer, for participants into aspects of everyday life, but it should not be ignored that the potential behavioural gain of freeriding is at the cost of a higher risk which is underlined by the higher involvement in accidents and experienced close calls offreeriders compared to slope skiers.

10 citations

References
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Journal ArticleDOI
TL;DR: Results of this investigation indicate that the Injury Severity Score represents an important step in solving the problem of summarizing injury severity, especially in patients with multiple trauma.
Abstract: A method for comparing death rates of groups of injured persons was developed, using hospital and medical examiner data for more than two thousand persons. The first step was determination of the extent to which injury severity as rated by the Abbreviated Injury Scale correlates with patient survival. Substantial correlation was demonstrated. Controlling for severity of the primary injury made it possible to measure the effect on mortality of additional injuries. Injuries that in themselves would not normally be life-threatening were shown to have a marked effect on mortality when they occurred in combination with other injuries. An Injury Severity Score was developed that correlates well with survival and provides a numerical description of the overall severity of injury for patients with multiple trauma. Results of this investigation indicate that the Injury Severity Score represents an important step in solving the problem of summarizing injury severity, especially in patients with multiple trauma.

8,174 citations

Journal ArticleDOI
TL;DR: Climbing frequency and technical difficulty are associated with climbing injuries occurring at both indoor and outdoor venues, particularly cumulative trauma to the upper extremities.
Abstract: Objectives: To determine the prevalence and nature of rock-climbing injuries, and the factors associated with these injuries. Design: A retrospective cross-sectional study. Setting: Rock climbers were recruited at five outdoor and six indoor climbing venues in the UK. Participants: 201 active rock climbers (163 male, 38 female climbers) aged 16–62 years. Assessment of risk factors: Rock climbing behaviours and key demographics. Main outcome measures: Injuries requiring medical attention or withdrawal from participation for ⩾1 day. Results: Around 50% of climbers had sustained ⩾1 injury in the past 12 months, causing a total of 275 distinct anatomical injuries. 21 climbers (10%) had sustained acute climbing injuries as a result of a fall, 67 (33%) had chronic overuse injuries, and 57 (28%) had acute injuries caused by strenuous climbing moves. Dedicated climbers participating in different forms of rock climbing more often and at a higher level of technical difficulty may be more prone to injury, particularly overuse injuries of the finger and shoulder. The principal sources of treatment or advice sought by climbers were physiotherapists (18%), other climbers (14%) and doctors (11%). Conclusions: Climbing frequency and technical difficulty are associated with climbing injuries occurring at both indoor and outdoor venues, particularly cumulative trauma to the upper extremities.

126 citations

Journal ArticleDOI
TL;DR: The NACA-scale adequately describes life threat in trauma victims and correlates well with morbidity and mortality and should be supplemented or replaced by a physiologically based prehospital severity score.
Abstract: The NACA-scale is used in many Austrian, German and Swiss emergency medical systems for demographic description of emergency patients. Little attention has been payed to the evaluation of its construct and predictive validity. In 427 consecutive trauma patients rescued in primary mission the NACA-Scale and the Injury Severity Score (ISS) were determined. Outcome data were obtained from medical charts and by written or telephone requests. Data were analysed with Spearman-Rank-Correlation. NACA-Grade and ISS-values showed only a moderate correlation with a considerably large spread (Rho = 0.721). Both severity scores demonstrated a good correlation to mortality (Rho = 0.976/0.994) and to transfer to an ICU (Rho = 0.964/0.943), as well a moderate correlation to the duration of ICU-stay (Rho = 0.722/0.756) and of hospital stay (Rho = 0.558/0.694). The NACA-scale adequately describes life threat in trauma victims and correlates well with morbidity and mortality. Thus, it is a valuable tool for demographic purposes in emergency medical systems. For more precise prehospital severity rating in trauma patients, the NACA-scale should be supplemented or replaced by a physiologically based prehospital severity score.

92 citations

Journal ArticleDOI
TL;DR: The results indicate that the most common rock climbing-related injuries are to the lower extremities and are fractures, sprains, and strains.

81 citations

Journal Article
TL;DR: In this paper, the authors investigated personality traits of high-risk sports athletes and compared the results to the results of non-risk sport athletes and non-athletes using the Big Five Observer Scale.
Abstract: The research investigated personality traits of high-risk sports athletes. The aim was to investigate the personality dimensions and compare the results to the results of non-risk sports athletes and non-athletes. Thirty eight high-risk sports athletes participated in the research (alpinists, sky divers, paragliders, white-water kayakers, downhill mountain-bikers, motocross riders, downhill skiers and ski jumpers). The non-risk sports athletes consisted of 38 swimmers, track athletes, sailors, flat-water kayakers, rowers, Nordic skiers, sports climbers and karatekas. The non-athletes were equalled with both groups in age and education and included 76 non-athletes. The Big Five Observer Scale was used. It was found that high-risk sports athletes scored highest in emotional stability, they were followed by the non-athletes and the lowest scores were achieved by non-risk sports athletes. The same order of groups was shown in conscientiousness and energy. Openness was highest in the non-risk sports athletes, followed by the non-athletes and the lowest score was achieved by the high-risk sports athletes. The differences in acceptability were not significant. Four out of five hypotheses were accepted. DIE PERSÖNLICHKEIT VON RISIKOREICHE SPORTARTEN TREIBENDEN SPORTLERN Zusammenfassung: Diese Studie untersuchte die Persönlichkeit der Sportler, die risikoreichen Sport treiben. Unser Ziel war es, die Persönlichkeitsdimensionen zu untersuchen und die Ergebnisse von Sportlern, die keinen risikoreichen Sport treiben, mit den Ergebnissen von Nichtsportlern zu vergleichen.

77 citations