Into the wild and on to the table: A Western Trauma Association multicenter analysis and comparison of wilderness falls in rock climbers and nonclimbers.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Bernard Matthew, Martin Matthew J, Corsa Josh, Robinson Bryce, Zeeshan Muhammad, Joseph Bellal, Morris David, Shillinglaw William, Schurr Michael, Smith Terrie, Lara Sabino, Brown Carlos, Harrell Kevin, Maxwell Robert, Berndtson Allison E, Curry Terry, Kaups Krista, Dirks Rachel, Rott Michael, Schroeppel Thomas, Stillman Zachery, Warriner Zachary, Inaba Kenji, Burlew Clay, Robinson Caitlin, Jackson Rebecca, Dunn Julie, Chapin Trinette, Wilson Alison, Moulton Steve, Phillips Ryan, Shahi Niti, Urban Shane, Velopulos Catherine, Davenport Daniel, C Bernard Andrew
Аннотация
METHODS: Data were collected from 17 centers in 11 states on all wilderness falls (fall from cliff: International Classification of Diseases, Ninth Revision, e884.1; International Classification of Diseases, 10th Revision, w15.xx) from 2006 to 2018 as a Western Trauma Association multicenter investigation. Demographics, injury characteristics, and care delivery were analyzed. Comparative analyses were performed for climbing versus nonclimbing mechanisms.
RESULTS: Over the 13-year study period, 1,176 wilderness fall victims were analyzed (301 climbers, 875 nonclimbers). Fall victims were male (76%), young (33 years), and moderately injured (Injury Severity Score, 12.8). Average fall height was 48 ft, and average rescue/transport time was 4 hours. Nineteen percent were intoxicated. The most common injury regions were soft tissue (57%), lower extremity (47%), head (40%), and spine (36%). Nonclimbers had a higher incidence of severe head and facial injuries despite having equivalent overall Injury Severity Score. On multivariate analysis, climbing remained independently associated with increased need for surgery but lower odds of composite intensive care unit admission/death. Contrary to studies of urban falls, height of fall in wilderness falls was not independently associated with mortality or Injury Severity Score.
CONCLUSION: Wilderness falls represent a unique population with distinct patterns of predominantly soft tissue, head, and lower extremity injury. Climbers are younger, usually male, more often discharged home, and require more surgery but less critical care.
LEVEL OF EVIDENCE: Epidemiological, Level IV.