title: Avalanche Fatalities in the United States: A Change in Demographics.
abstract: OBJECTIVE
  To describe demographic patterns in avalanche fatalities in the United States during the past 6 decades according to geographic location and preavalanche activity.
  
  
  METHODS
  The Colorado Avalanche Information Center currently manages the National Avalanche Accident Dataset. This dataset describes deidentified avalanche fatalities beginning in 1951. Covariates included age, sex, month, state of occurrence, and preavalanche activity. Both absolute and proportional avalanche fatalities were calculated by year and by each covariate. A linear regression model was used to trend the proportion of avalanche fatalities stratified by covariate.
  
  
  RESULTS
  There were 925 recorded avalanche fatalities in the United States between 1951 and 2013. There were an average of 15 ± 11 fatalities/y (mean ± SD; range, 0 to 40 fatalities/y). The mean (+/- SD) age was 29 ± 6.6 years (range, 6-67 years), and 86% were men. Total avalanche fatalities have increased linearly (R(2) = 0.68). Despite the highest number of total deaths in Colorado (n = 253), the proportion of avalanche fatalities in Colorado decreased (-5% deaths/decade; P = .01). Snowmobilers are now the largest group among fatalities and accounted for 23% of deaths (n = 213). The proportion of snowmobile fatalities has increased (+7% deaths/decade; P < .01), as has the proportion of snowboarder fatalities (+2% deaths/decade; P < .01).
  
  
  CONCLUSIONS
  Avalanche fatalities have increased. This is most likely related to an overall rise in backcountry utilization. Fatalities have increased among snowmobilers and snowboarders. Despite a rise in backcountry utilization, avalanche fatalities in Colorado are decreasing. A strategy of focused training and education aimed toward at-risk groups could result in lower avalanche fatalities.
authors.affiliation: Denver Health Residency in Emergency Medicine, Denver, CO (Drs Jekich and Nacht).
authors.forename: Brian M
authors.initials: BM
authors.lastname: Jekich
authors.affiliation: Valley View Hospital, Glenwood Springs, CO (Dr Drake).
authors.forename: Brandy D
authors.initials: BD
authors.lastname: Drake
authors.affiliation: Denver Health Residency in Emergency Medicine, Denver, CO (Drs Jekich and Nacht).
authors.forename: Jacob Y
authors.initials: JY
authors.lastname: Nacht
authors.affiliation: Altitude Research Center (Mr Nichols) and Department of Emergency Medicine (Drs Jekich, Nacht, Ginde, and Davis), University of Colorado School of Medicine, Aurora, CO.
authors.forename: Andrew
authors.initials: A
authors.lastname: Nichols
authors.affiliation: Altitude Research Center (Mr Nichols) and Department of Emergency Medicine (Drs Jekich, Nacht, Ginde, and Davis), University of Colorado School of Medicine, Aurora, CO.
authors.forename: Adit A
authors.initials: AA
authors.lastname: Ginde
authors.affiliation: Altitude Research Center (Mr Nichols) and Department of Emergency Medicine (Drs Jekich, Nacht, Ginde, and Davis), University of Colorado School of Medicine, Aurora, CO. Electronic address: christopher.davis@ucdenver.edu.
authors.forename: Christopher B
authors.initials: CB
authors.lastname: Davis
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D055875:Avalanches / Q000401:mortality*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009051:Mountaineering / Q000706:statistics & numerical data*; D012621:Seasons; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: avalanche; backcountry skier; backcountry snowboarder; snowmobiler; trauma