title: Epidemiology and mortality of glacier crevasse accidents.
abstract: BACKGROUND
  Crevasse accidents can lead to severe injuries and even death, but little is known about their epidemiology and mortality.
  
  
  METHODS
  We retrospectively reviewed helicopter-based emergency services rescue missions for crevasse victims in Switzerland between 2000 and 2010. Demographic and epidemiological data were collected. Injury severity was graded according to the National Advisory Committee for Aeronautics (NACA) score.
  
  
  RESULTS
  A total of 415 victims of crevasse falls were included in the study. The mean victim age was 40 years (SD 13) (range 6-75), 84% were male, and 67% were foreigners. The absolute number of victims was much higher during the months of March, April, July, and August, amounting to 73% of all victims; 77% of victims were practicing mountaineering or ski touring. The mean depth of fall was 16.5m (SD 9.0) (range 1-35). Overall on-site mortality was 11%, and it was higher during the ski season than the ski offseason (14% vs. 7%; P=0.01), for foreigners (14% vs. 5%; P=0.01), and with higher mean depth of fall (22 vs. 15m; P=0.01). The NACA score was ≥4 for 22% of the victims, indicating potential or overt vital threatening injuries, but 24% of the victims were uninjured (NACA 0). Multivariable analyses revealed that depth of the fall, summer season, and snowshoeing were associated with higher NACA scores, whereas depth of the fall, snowshoeing, and foreigners but not season were associated with higher risk of death.
  
  
  CONCLUSIONS
  The clinical spectrum of injuries sustained by the 415 patients in this study ranged from benign to life-threatening. Death occurred in 11% of victims and seems to be determined primarily by the depth of the fall.
authors.affiliation: Emergency Service, Lausanne University Hospital, 1011 Lausanne, Switzerland; Air-Glaciers SA et GRIMM, Maison FXB du Sauvetage, 1950 Sion, Switzerland. Electronic address: Mathieu.Pasquier@chuv.ch.
authors.forename: Mathieu
authors.initials: M
authors.lastname: Pasquier
authors.affiliation: Institute for Social and Preventive Medicine (IUMSP), Biopôle 2, Route de la Corniche 10, 1010 Lausanne, Switzerland.
authors.forename: Patrick
authors.initials: P
authors.lastname: Taffé
authors.affiliation: Swiss Air Ambulance Rega, P.O. Box 1414, CH-8058 Zurich Airport, Switzerland.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Kottmann
authors.affiliation: Fachverantwortlicher Sicherheit, Schweizer Alpen-Club SAC, CH-3068 Utzigen, Switzerland.
authors.forename: Ueli
authors.initials: U
authors.lastname: Mosimann
authors.affiliation: Air Zermatt AG, Raron, P.O. Box 1, CH-3942 Raron, Switzerland; Solothurn Hospitals, CH-4500 Solothurn, Switzerland.
authors.forename: Oliver
authors.initials: O
authors.lastname: Reisten
authors.affiliation: Emergency Service, Lausanne University Hospital, 1011 Lausanne, Switzerland.
authors.forename: Olivier
authors.initials: O
authors.lastname: Hugli
mesh_terms: D000059:Accidents / Q000401:mortality / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D000368:Aged; D017732:Air Ambulances / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D004632:Emergency Medical Services / Q000458:organization & administration / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D046448:Ice Cover; D007223:Infant; D008297:Male; D008875:Middle Aged; D009051:Mountaineering / Q000706:statistics & numerical data*; D018635:Rescue Work; D012189:Retrospective Studies; D012621:Seasons; D012720:Severity of Illness Index; D012865:Skiing / Q000706:statistics & numerical data*; D013557:Switzerland / Q000453:epidemiology; D014947:Wounds and Injuries / Q000401:mortality*
keywords: Crevasse; Emergency Medical Services; Epidemiology; Hypothermia; Mountain Medicine; Trauma