title: Skiing and snowboarding injuries and their impact on the emergency care system in South Tyrol: a restrospective analysis for the winter season 2001--2002.
abstract: OBJECTIVE
  To evaluate the incidence and the pattern of skiing and snowboarding injuries in South Tyrol and their impact on the emergency medical system in the winter season 2001--2002 in an attempt to rationalize and improve the emergency care and assist in prevention strategies.
  
  
  METHODS
  All medical records of patients referred to our emergency department (ED) that sustained a skiing or snow-boarding injury during the study period were retrospectively reviewed. Age, sex, local or non-local residency, type of injury, data and time of accident, type of transport to the hospital, hospital admission or ED discharge, Injury Severity Score, outcome (including mortality) were evaluated. On site mortality data were obtained from the emergency call-center registry. Ski resorts utilization was estimated from the data published by the Regional Office of Cable Transport.
  
  
  RESULTS
  For the period analyzed approximately 2,500,000 skier and snowboarder days were recorded in the whole region of which about 500,000 were attributed to the four nearby ski resorts that refer to our hospital. Of the 1087 patients, 794 were skiers and 294 were snowboarders. Snow-boarders were younger than skiers (mean age 20 and 36 respectively, p = 0.001). Females were equally represented in the two groups. Male patients, children, senior skiers and non-local residents suffered from more severe injuries than their corresponding classes (p < 0.01, p = 0.002, p = 0.02, p = 0.000 respectively). Critical injuries (ISS > or = 25) were homogeneously spread in the groups, with the exception of the non-local resident patients that showed a higher incidence (p < 0.02). No difference in severity was found between skiers and snowboarders. The incidence was 2.05 per 1,000 skier-days. Mortality rate was 1.6 per 1,000,000 skier-days. The pattern of injury was different: snowboarders showed more forearm and wrist trauma and skiers more lower extremity injuries. 208 patients were hospitalized and the mean length of stay was 4.5 days. Head trauma and fractures were the most common diagnosis of admission. The lack of field triage led to 12% of unjustified helicopter transfer and 9.6% of avoidable ambulance transport.
  
  
  CONCLUSIONS
  Incidence, pattern of injuries and mortality from skiing and snowboarding accidents in South Tyrol resemble those reported in other part of the world. Nevertheless, strategies for prevention are needed. The routine use of helmets should be enforced by law. Dangerous behaviors should be prosecuted. Skiers and snowboarders should be made aware that skiing beyond their technical ability can be life-threatening.
authors.affiliation: Emergency Department, Regional Hospital of Bolzano-Bozen, Italy. stefano.corra@asbz.it
authors.forename: Stefano
authors.initials: S
authors.lastname: Corra
authors.forename: Alessandro
authors.initials: A
authors.lastname: Conci
authors.forename: Giorgio
authors.initials: G
authors.lastname: Conforti
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Sacco
authors.forename: Franco
authors.initials: F
authors.lastname: De Giorgi
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D004632:Emergency Medical Services / Q000191:economics / Q000706:statistics & numerical data*; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012621:Seasons; D017678:Sex Distribution; D012865:Skiing / Q000293:injuries* / Q000706:statistics & numerical data*; D016019:Survival Analysis; D014187:Transportation of Patients / Q000706:statistics & numerical data