title: Analysis of Surfing Injuries Presenting in the Acute Trauma Setting.
abstract: OBJECTIVE
  Surfing is a rapidly growing major worldwide sport; however, little is understood regarding severe injuries and resulting hospital admissions. This study explores surfing-related injuries in the major surfing hub of San Diego presenting in the acute trauma setting. The purpose of this study is to address the void of information regarding severe surfing injuries in the trauma setting, including injury patterns, associated hospitalization course, and risk factors. Understanding the injury patterns in surfing accidents is crucial for proper management of surfing injuries.
  
  
  METHODS
  A retrospective analysis was performed of all surfing-related injuries in a Level 1 trauma center between 2000 and 2016.
  
  
  RESULTS
  A total of 93 patients were identified. Body parts most commonly affected include the head (42, 46%), face (21, 22%), and spine (47, 51%). Twenty-eight (30%) patients required surgical intervention, including 19 for spinal injuries, 3 for facial injuries, 4 for upper extremity injuries, and 2 for lower extremity injuries. The distribution for most presentations (55, 59%) occurred in the summer months between July and September. The Injury Severity Score demonstrated strong positive correlation with the length of hospital stay, with a Pearson coefficient of 0.52 (P < 0.01). The average length of hospitalization was 5.8 days, with intensive care unit level care required in 49% (46) patients and average length of intensive care unit stay of 5.5 days. Alcohol content was tested in 84% (78) of patients and found positive in 10% (8) of tested patients. Drug screening was performed in 70% (64) patients and found positive in 38% (24) of tested patients.
  
  
  CONCLUSIONS
  Surfing, although a relatively safe sport, is not without major risks. In contrast with other studies, we found a high proportion of head, face, and spine injuries in patients presenting with surfing injuries in the trauma setting, consistent with its presentation as a high velocity and high impact injury. With plastic surgeons often treating severe head and facial injuries, understanding the injury patterns in severe surfing accidents is crucial for proper management. High rates of positive alcohol and drug screening signal the importance to bring awareness to the dangers of surfing under the influence.
authors.affiliation: From the *Division of Plastic Surgery, University of California, San Diego, CA; and †Division of Plastic Surgery, Medical University of South Carolina, Charleston, SC.
authors.forename: Kevin T
authors.initials: KT
authors.lastname: Jubbal
authors.forename: Charlie
authors.initials: C
authors.lastname: Chen
authors.forename: Todd
authors.initials: T
authors.lastname: Costantini
authors.forename: Fernando
authors.initials: F
authors.lastname: Herrera
authors.forename: Marek
authors.initials: M
authors.lastname: Dobke
authors.forename: Ahmed
authors.initials: A
authors.lastname: Suliman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002140:California / Q000453:epidemiology; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000453:epidemiology; D014193:Trauma Centers; D000073678:Water Sports / Q000293:injuries*; D014947:Wounds and Injuries / Q000453:epidemiology / Q000628:therapy*