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Journal Article

Citation

Baschera D, Hasler RM, Taugwalder D, Exadaktylos A, Raabe A. J. Neurotrauma 2014; 32(8): 557-562.

Affiliation

Bern University Hospital, Neurosurgery , Freiburgstrasse , Bern, Switzerland, 3008 ; dbaschera@bluewin.ch.

Copyright

(Copyright © 2014, Mary Ann Liebert Publishers)

DOI

10.1089/neu.2014.3604

PMID

25244343

Abstract

The association between helmet use during alpine skiing and incidence and severity of head injuries was analyzed. All patients admitted to a level 1 trauma center for traumatic brain injuries (TBI) sustained due to skiing accidents during the seasons 2000/01-2010/11 were eligible. Primary outcome was the association between helmet use and severity of TBI measured by Glasgow Coma Scale (GCS), CT-results, and necessity of neurosurgical intervention. Of 1362 patients injured during alpine skiing, 245 (18%) sustained TBI and were included. TBI was fatal in 3%. Head injury was minor (GCS 13-15) in 76%, 6% moderate and 14% severe. Number and percentage of TBI patients showed no significant trend over the investigated seasons. Forty-five percent of the 245 patients had pathological CT-findings and 26% of these required neurosurgical intervention. Helmet use increased from 0% in 2000/2001 to 71% in 2010/2011 (p<0.001). The main analysis, comparing TBI in patients with or without a helmet, showed an adjusted Odds Ratio (OR) of 1.44 (p=0.430) for suffering moderate to severe head injury in helmet users. Analyses comparing off-piste to on-slope skiers revealed a significantly increased OR among off-piste skiers of 7.62 (p=0.004) for sustaining a TBI requiring surgical intervention. Despite increases in helmet use we found no decrease in severe TBI among alpine skiers. Logistic regression analysis showed no significant difference in TBI with regard to helmet use, but increased risk for off-piste skiers. The limited protection of helmets and dangers of skiing off-piste should be targeted by prevention programs. Helmet; skiing; head trauma; TBI.


Language: en

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