Abstract
Aim
Asphyxia is the primary cause of death among avalanche victims. Avalanche airbags
can lower mortality by directly reducing grade of burial, the single most important
factor for survival. This study aims to provide an updated perspective on the effectiveness
of this safety device.
Methods
A retrospective analysis of avalanche accidents involving at least one airbag user
between 1994 and 2012 in Austria, Canada, France, Norway, Slovakia, Switzerland and
the United States. A multivariate analysis was used to calculate adjusted absolute
risk reduction and estimate the effectiveness of airbags on grade of burial and mortality.
A univariate analysis was used to examine causes of non-deployment.
Results
Binomial linear regression models showed main effects for airbag use, avalanche size
and injuries on critical burial, and for grade of burial, injuries and avalanche size
on mortality. The adjusted risk of critical burial is 47% with non-inflated airbags
and 20% with inflated airbags. The adjusted mortality is 44% for critically buried
victims and 3% for non-critically buried victims. The adjusted absolute mortality
reduction for inflated airbags is −11 percentage points (22% to 11%; 95% confidence
interval: −4 to −18 percentage points) and adjusted risk ratio is 0.51 (95% confidence
interval: 0.29 to 0.72). Overall non-inflation rate is 20%, 60% of which is attributed
to deployment failure by the user.
Conclusion
Although the impact on survival is smaller than previously reported, these results
confirm the effectiveness of airbags. Non-deployment remains the most considerable
limitation to effectiveness. Development of standardized data collection protocols
is encouraged to facilitate further research.
Keywords
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References
- Avalanche rescue statistics.([accessed 10.03.14])
- Patterns of death among avalanche fatalities: a 21 year review.CMAJ. 2009; 180: 507-511
- Resuscitation of avalanche victims: Evidence-based guidelines of the international commission for mountain emergency medicine (ICAR MEDCOM): intended for physicians and other advanced life support personnel.Resuscitation. 2013; 84: 539-546
- Pattern and severity of injury in avalanche victims.High Alt Med Biol. 2007; 8: 56-61
- Cause of death in avalanche fatalities.Wilderness Environ Med. 2007; 18: 293-297
- Comparison of avalanche survival patterns in Canada and Switzerland.CMAJ. 2011; 183: 789-795
- Field management of avalanche victims.Resuscitation. 2001; 51: 7-15
- Avalanche survival chances.Nature. 1994; 368: 21
- Inverse grading in granular flow..(PhD thesis) École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland.2000 ([accessed 10.03.14])
- Staying alive in avalanche terrain.2nd ed. The Mountaineers, Seattle, WA2008
- The impact of avalanche rescue devices on survival.Resuscitation. 2007; 75: 476-483
- Observation guidelines and recording standards for weather, snowpack, and avalanches.Canadian Avalanche Association, Revelstoke, Canada2007
- What's the Risk? A simple approach for estimating adjusted risk measures from nonlinear models including logistic regression.Health Serv Res. 2009; 44: 288-302
Article info
Publication history
Published online: June 05, 2014
Accepted:
May 21,
2014
Received in revised form:
May 15,
2014
Received:
March 13,
2014
Footnotes
☆A Spanish translated version of the abstract of this article appears as Appendix in the final online version at http://dx.doi.org/10.1016/j.resuscitation.2014.05.025.
Identification
Copyright
© 2014 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
