title: Patterns of death among avalanche fatalities: a 21-year review.
abstract: BACKGROUND
  Avalanches are a significant cause of winter recreational fatalities in mountain regions. The purpose of this study was to determine the relative contributions of trauma and asphyxia to avalanche deaths.
  
  
  METHODS
  We reviewed all avalanche fatalities between 1984 and 2005 that had been investigated by the offices of the British Columbia Coroners Service and the Chief Medical Examiner of Alberta. In addition, we searched the database of the Canadian Avalanche Centre for fatal avalanche details. We calculated injury severity scores for all victims who underwent autopsy.
  
  
  RESULTS
  There were 204 avalanche fatalities with mortality information over the 21-year study period. Of these, 117 victims underwent autopsy, and 87 underwent forensic external examination. Asphyxia caused 154 (75%) deaths. Trauma caused 48 (24%) deaths, with the rate of death from trauma ranging from 9% (4/44) for snowmobilers to 42% (5/12) for ice climbers. In addition, 13% (12/92) of the asphyxia victims who underwent autopsy had major trauma, defined as an injury severity score of greater than 15. Only 48% (23/48) of victims for whom trauma was the primary cause of death had been completely buried.
  
  
  CONCLUSIONS
  Asphyxia and severe trauma caused most avalanche fatalities in western Canada. The relative rates differed between snowmobilers and those engaged in other mountain activities. Our findings should guide recommendations for safety devices, safety measures and resuscitation.
authors.affiliation: Department of Emergency Medicine, Mineral Springs Hospital, Banff, Alberta.
authors.forename: Jeff
authors.initials: J
authors.lastname: Boyd
authors.forename: Pascal
authors.initials: P
authors.lastname: Haegeli
authors.forename: Riyad B
authors.initials: RB
authors.lastname: Abu-Laban
authors.forename: Michael
authors.initials: M
authors.lastname: Shuster
authors.forename: John C
authors.initials: JC
authors.lastname: Butt
mesh_terms: D000293:Adolescent; D000328:Adult; D000416:Alberta / Q000453:epidemiology; D000465:Algorithms; D001237:Asphyxia / Q000401:mortality*; D055875:Avalanches / Q000401:mortality*; D001955:British Columbia / Q000453:epidemiology; D016887:Cardiopulmonary Resuscitation; D002423:Cause of Death; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009051:Mountaineering / Q000293:injuries; D018635:Rescue Work; D012189:Retrospective Studies; D012306:Risk; D012865:Skiing / Q000293:injuries; D038161:Snow Sports / Q000293:injuries; D014947:Wounds and Injuries / Q000401:mortality*