Reliability of Ski Patrol Severe Head Injury Assessment

Abstract

Head and neck injuries account for a disproportionate number of cases of severe trauma and death among skiers and snowboarders. Helmets have been recommended in the literature for over 25 years, however their true effectiveness at preventing severe head injury (SHI) has been difficult to ascertain. Many studies have used data gathered by ski patrol reports however it is not clear that ski-patrol assessment of SHI accurately corresponds to final medical assessment. PURPOSE: The purpose of this study was threefold. First, to examine the rate of agreement between ski patrol and ER diagnosis of SHI. Second, to examine the relationship between helmet use and patient's age, sex, self-reported ability, and mode (i.e., ski or snowboard). Finally, to examine whether the use of a helmet predicted final diagnosis of SHI. METHODS: This study conducted a retrospective review of existing patient data from the Killington Ski Clinic between the 2001-2009 ski seasons. Inclusion criteria included any patient who was identified as having a SHI by ski patrol. Data was collected from a total of 57 patients, 71.9% males, average of 30 (SD=14.9) years old, 53.8% snowboarders and 46.2% alpine skiers. Rate of ski patrol and ER agreement was calculated as a percentage. Chi-square analyses were conducted to examine relationships between helmet use patient demographics. Logistic regression was conducted to examine helmet use as a predictor of SHI. RESULTS: Results indicate a 17% rate of agreement between ski patrol and ER diagnosis of SHI. There was a significant relationship between age and helmet use χ2=9.12 (2,48), p<.01, with older patients (40-70 yrs) wearing helmets more frequently. Helmet use was not a significant predictor of SHI. CONCLUSION: Helmet use did not influence ski patrol assessment of the risk of SHI. There is a discrepancy between ski patrol assessment of the risk of SHI and ultimate clinical diagnosis. Future studies examining the occurrence of SHI among skiers and snowboarders should focus on data from physician diagnosis for more accurate results.