title: Let it snow: how snowfall and injury mechanism affect ski and snowboard injuries in Vail, Colorado, 2011-2012.
abstract: BACKGROUND
  Current research examining the impact of mechanism of injury and daily snowfall amounts on injury severity among skiers and snowboarders is limited. The purpose of this study was to define correlations between injury mechanism and daily snowfall on injury patterns and severity among skiers and snowboarders.
  
  
  METHODS
  This observational study analyzed daily snowfall measurements coupled with trauma admissions during the 2011 and 2012 ski seasons from a Level III trauma center servicing a large North American ski resort. Post hoc adjusted analyses and multivariate modeling was used to determine independent predictors of increased injury severity.
  
  
  RESULTS
  Six hundred forty-four trauma admissions were analyzed, with primary research considerations detailing the variances in injury severity resulting from collisions with other skiers or snowboarders and daily total snowfall. Findings demonstrated that collisions were independently associated with increased (1) injury severity (Injury Severity Score [ISS ≥ 16]) (odds ratio [OR], 3.9; 95% confidence interval [CI], 2.0-7.6; p < 0.001), (2) thoracic injury severity (Abbreviated Injury Scale [AIS] score ≥ 3) (OR, 7.5; 95% CI, 3.7-15.0; p < 0.001), and (3) renal injuries (OR, 3.2; 95% CI, 1.2-8.1; p = 0.017) as well as and axial skeleton fractures (OR, 4.5; 95% CI, 2.6-7.7; p < 0.001). In addition, mean ISS was significantly higher in the setting of a collision when compared with a fall (8.6 vs. 5.8; p < 0.001). Findings regarding total snowfall demonstrate a negative correlation between snowfall and injury severity (r = -0.08, p = 0.05); the majority (65.5%) of injuries were sustained when there was 1 inch or less of recent snowfall, and a snowfall total of 2 inches or less was independently associated with increased injury severity (ISS ≥ 16) (OR, 3.1; 95% CI, 1.1-9.1; p = 0.036).
  
  
  CONCLUSIONS
  Collisions between snowsport enthusiasts and total trace snowfall predict an increase in injury severity among alpine skiers and snowboarders. Findings from this project may lead to an increased understanding of predictive factors contributing to injury, alter the diagnostic evaluation of patients, provide educational opportunities for alpine enthusiasts, and enhance resort safety initiatives tailored to ambient conditions.
authors.affiliation: Trauma Services, Vail Valley Medical Center, Vail, Colorado 81657, USA. jason.moore@vvmc.com
authors.forename: S Jason
authors.initials: SJ
authors.lastname: Moore
authors.forename: Dana
authors.initials: D
authors.lastname: Knerl
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003120:Colorado / Q000453:epidemiology; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012865:Skiing / Q000293:injuries*; D012914:Snow; D055815:Young Adult