Skiing, snowboarding injuries more serious -- skull and face fractures -- in younger children

October 25, 2019

NEW ORLEANS - Winter sports like skiing and snowboarding are a great way to keep kids active in the winter, but they are also linked to injuries and for younger children those injuries are more likely to involve fractures to the head or face, according to new research being presented at the American Academy of Pediatrics (AAP) 2019 National Conference & Exhibition.

The research abstract, "Pediatric Snow Sport Injuries Differ By Age," will be presented from 4:20-4:25 p.m. Sunday, October 27, in the Jefferson Ballroom at the Hilton New Orleans Riverside during the AAP 2019 National Conference & Exhibition.

Researchers looked at a cross-sectional analysis of the 2009 and 2012 Kids' Inpatient Database, examining 845 hospital admissions for snow sport injuries in kids. They found that over half of hospitalized children required major surgical intervention, and elementary school-age children were at significantly greater odds than those older than high school to suffer a skull or facial fracture. Middle school, high school and those older were more likely to experience intra-abdominal injury.

"We were interested to find that the type of injuries children had varied according to their age, and we believe these findings can better inform educational and legislative efforts aimed at reducing injuries in children who participate in winter sports," said Robert J. McLoughlin, MD, MSCI. "These injuries can be very severe and should be a concern to any parent with a child involved in these sports. Almost a quarter--23% of children--suffered intercranial injuries, which we found were more common among young children."

Of the young skiers who were admitted into hospitals in this research, 75.8% were male and 87.4% white. The injuries included: lower extremity fractures (28.7%), intracranial injury (22.7%), splenic injury (15.6%), upper extremity fracture (15.5%), and skull fracture (9.1%).

Shruthi Srinivas will present an abstract of the study, available below, from 4:20-4:25 p.m. ET on Sunday, October 27, in the Jefferson Ballroom at the Hilton New Orleans Riverside.

In addition, Ms. Srinivas and Michael Hirsh, MD, FAAP, will give a brief presentation about the research abstract and be available for interviews during a press conference starting at noon on Sunday, Oct. 27, in rooms 208-209 (Press Office) of the Ernest N. Morial Convention Center. During the meeting, you may reach AAP media relations staff in the National Conference Press Room at 504-670-5406.

Please note: only the abstract is being presented at the meeting. In some cases, the researcher may have more data available to share with media, or may be preparing a longer article for submission to a journal.
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The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. For more information, visit http://www.aap.org. Reporters can access the meeting program and other relevant meeting information through the AAP meeting website at http://www.aapexperience.org.

Abstract Title: Pediatric Snow Sport Injuries Differ by Age Robert McLoughlin, MD

Background: Unintentional injury is the leading cause of death among pediatric patients in the United States. There were an estimated 13,436 injuries related to snowboarding or downhill skiing in those younger than 15 in 2015, with 4.8% requiring admission. Skiing and snowboarding are high-risk sports due to the ever-present danger of serious injury even when using protective equipment. We hypothesized that snow sport related injury patterns would differ based on patient age. Methods: A cross-sectional analysis of the 2009 and 2012 Kids' Inpatient Database was performed. We identified cases of snow sport injuries using external cause of injury codes. Patient characteristics and injuries were analyzed using ICD-9 codes, and national estimates were obtained using case weighting. Multivariable logistic regression was used to assess for confounders. Results: A total of 845 admissions for pediatric snow sport injuries were identified. The patients were predominately male (75.8%), non-Hispanic white (87.4%), of high-school age (44.0%), in the highest income quartile (49.5%), and had mean age 14.6 years (95% CI: 14.1-15.1). Those injured had a mean new injury severity score of 9.7. Over half of hospitalized patients required major surgical intervention. Predominant injuries included lower extremity fractures (28.7%), intracranial injury (22.7%), splenic injury (15.6%), upper extremity fracture (15.5%), and skull fracture (9.1%). There was a direct correlation in the prevalence of injury with increasing age for intra-abdominal injuries and an indirect relationship for skull fractures and lower extremity fractures. Using adjusted logistic regression, elementary school-age children were at significantly greater odds than those older than high school to suffer a skull or facial fracture (aOR 2.80, 95% CI: 1.15-6.83). However, middle school (aOR 2.50, 95% CI: 1.04-5.98), high school (aOR 2.25, 95% CI: 1.1-4.63), and post-high school (aOR 2.79, 95% CI: 1.29-6.06) were more likely to experience intra-abdominal injury. Conclusion: Snow sport injuries are a common cause of injury in children and adolescents with varying injury patterns based on age. Young children are more likely to suffer skull or facial fractures, while older children have more intra-abdominal injuries. This difference suggests a variation in the mechanism of injury. Aged-based education programs should be implemented to help address and prevent these injuries.

AAP contacts: Laura Alessio, 630-626-6276, LAlessio@aap.org or Lisa Black, 630-626-6084, LBlack@aap.org

American Academy of Pediatrics

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