• Matthew Bernard, Matthew J Martin, Josh Corsa, Bryce Robinson, Muhammad Zeeshan, Bellal Joseph, David Morris, William Shillinglaw, Michael Schurr, Terrie Smith, Sabino Lara, Carlos Brown, Kevin Harrell, Robert Maxwell, Allison E Berndtson, Terry Curry, Krista Kaups, Rachel Dirks, Michael Rott, Thomas Schroeppel, Zachery Stillman, Zachary Warriner, Kenji Inaba, Clay Burlew, Caitlin Robinson, Rebecca Jackson, Julie Dunn, Trinette Chapin, Alison Wilson, Steve Moulton, Ryan Phillips, Niti Shahi, Shane Urban, Catherine Velopulos, Daniel Davenport, and C BernardAndrewA.
• From the Department of Surgery, UK Chandler Medical Center (M.B.), Lexington, Kentucky; Department of Surgery, University of Kentucky (M.B., D.D., A.C.B.), Lexington, Kentucky; Department of Surgery, Harborview Medical Center (J.C., B.R.), University of Washington, Seattle, Washington; Department of Surgery, University of Arizona (M.Z., B.J.), Tucson, Arizona; Department of Surgery, Intermountain Medical Center (D.M.), Salt Lake City, Utah; Department of Surgery, Mission Hospital (W.S., M.S., T.S.), Asheville, North Carolina; Department of Surgery, Dell Medical School (S.L., C.B.), University of Texas at Austin; Department of Surgery, University of Tennessee-Chattanooga (K.H., R.M.); University of California, San Diego (A.E.B., T.C.); University of California, San Francisco, Fresno (K.K., R.D.); Department of Surgery, Legacy Emanuel Medical Center (M.J.M., M.R.), Portland, Oregon; Department of Surgery, UC Health Memorial Hospital Central (T.S., Z.S.), Colorado Springs, Colorado; Department of Surgery, Los Angeles County-University of Southern California (Z.W., K.I.); Department of Surgery, Denver Health (C.B., C.R., R.J.), Denver, Colorado; Department of Surgery, Medical Center of the Rockies (J.D., T.C.), University of Colorado Health, Ft Loveland, Colorado; Department of Surgery, West Virginia University (A.W.), Morgantown, West Virginia; Department of Surgery, Children's Hospital Colorado (S.M., R.P., N.S.), Aurora, Colorado; Department of Surgery, UC Health University of Colorado Hospital (S.U.), Aurora, Colorado; and Department of Surgery, School of Medicine (C.V.), University of Colorado, Aurora, Colorado.
• J Trauma Acute Care Surg. 2020 Sep 1; 89 (3): 570-575.

BackgroundWilderness activities expose outdoor enthusiasts to austere environments with injury potential, including falls from height. The majority of published data on falls while climbing or hiking are from emergency departments. We sought to more accurately describe the injury pattern of wilderness falls that lead to serious injury requiring trauma center evaluation and to further distinguish climbing as a unique pattern of injury.MethodsData 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.ResultsOver 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.ConclusionWilderness 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 EvidenceEpidemiological, Level IV.

27 keywords...

hide…