An analysis of head injuries among skiers and snowboarders

J Trauma. 2002 Oct;53(4):695-704. doi: 10.1097/00005373-200210000-00013.


Background: Head injury is the leading cause of death and critical injury in skiing and snowboarding accidents.

Methods: Data relating to head injuries occurring on the ski slopes were collected from the trauma registry of a Level I trauma center located near a number of ski resorts.

Results: From 1982 to 1998, 350 skiers and snowboarders with head injuries were admitted to our Level I trauma center. Most of the injuries were mild, with Glasgow Coma Scale (GCS) scores of 13 to 15 in 81% and simple concussion in 69%. However, 14% of patients had severe brain injuries, with GCS scores of 3 to 8, and the overall mortality rate was 4%. Collision with a tree or other stationary object (skier-tree) was the mechanism of injury in 47% of patients; simple falls in 37%; collision with another skier (skier-skier) in 13%; and major falls in 3%. Skier-tree collision and major falls resulted in a higher percentage of severe injuries, with GCS scores of 3 to 8 in 24% and 20%, respectively, and mean Injury Severity Scores of 14 and 17, respectively. Mortality from skier-tree collision was 7.2%, compared with 1.6% in simple falls and no deaths from skier-skier collision or major falls. The risk of sustaining a head injury was 2.23 times greater for male subjects compared with female subjects, 2.81 times higher for skiers/boarders < or = 35 years of age compared with those > 35 years, and 3.04 times higher for snowboarders compared with skiers.

Conclusion: Skier-tree collision was the most common mechanism for head injuries in patients admitted to our Level I trauma center, and resulted in the most severe injuries and the highest mortality rate. Because most traumatic brain injuries treated at our facility resulted from a direct impact mechanism, we believe that the use of helmets can reduce the incidence and severity of head injuries occurring on the ski slopes.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Brain Injuries / classification
  • Brain Injuries / pathology
  • Child
  • Craniocerebral Trauma* / classification
  • Craniocerebral Trauma* / pathology
  • Female
  • Head Protective Devices
  • Humans
  • Male
  • Middle Aged
  • Odds Ratio
  • Risk Factors
  • Skiing / injuries*