• Mathieu Pasquier, Patrick Taffé, Alexandre Kottmann, Ueli Mosimann, Oliver Reisten, and Olivier Hugli.
• Emergency Service, Lausanne University Hospital, 1011 Lausanne, Switzerland; Air-Glaciers SA et GRIMM, Maison FXB du Sauvetage, 1950 Sion, Switzerland. Electronic address: Mathieu.Pasquier@chuv.ch.
• Injury. 2014 Nov 1;45(11):1700-3.

IntroductionCrevasse accidents can lead to severe injuries and even death, but little is known about their epidemiology and mortality.MethodsWe retrospectively reviewed helicopter-based emergency services rescue missions for crevasse victims in Switzerland between 2000 and 2010. Demographic and epidemiological data were collected. Injury severity was graded according to the National Advisory Committee for Aeronautics (NACA) score.ResultsA total of 415 victims of crevasse falls were included in the study. The mean victim age was 40 years (SD 13) (range 6-75), 84% were male, and 67% were foreigners. The absolute number of victims was much higher during the months of March, April, July, and August, amounting to 73% of all victims; 77% of victims were practicing mountaineering or ski touring. The mean depth of fall was 16.5m (SD 9.0) (range 1-35). Overall on-site mortality was 11%, and it was higher during the ski season than the ski offseason (14% vs. 7%; P=0.01), for foreigners (14% vs. 5%; P=0.01), and with higher mean depth of fall (22 vs. 15m; P=0.01). The NACA score was ≥4 for 22% of the victims, indicating potential or overt vital threatening injuries, but 24% of the victims were uninjured (NACA 0). Multivariable analyses revealed that depth of the fall, summer season, and snowshoeing were associated with higher NACA scores, whereas depth of the fall, snowshoeing, and foreigners but not season were associated with higher risk of death.ConclusionThe clinical spectrum of injuries sustained by the 415 patients in this study ranged from benign to life-threatening. Death occurred in 11% of victims and seems to be determined primarily by the depth of the fall.Copyright © 2014 Elsevier Ltd. All rights reserved.

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