Epidemiology of Aquatic and Recreational Water Sport Injuries: A Case-Control Analysis

Abstract

The purposes of the current investigation are to evaluate the epidemiology of water sport injuries at a coastal tertiary trauma center and to determine the association of these activities with spinal column injury and to determine whether aquatic trauma injuries differ significantly from those that occur terrestrially. A retrospective review of a consecutive series of 105 patients with aquatic-based mechanisms of injury admitted to a Level II trauma center over a 3-year period, as well as a matched control cohort with terrestrial-based mechanisms of injury, was conducted. Patients were treated at a Level II trauma center from January 1, 2008, to December 31, 2010. All patients received a full trauma work-up on arrival. Patients were identified retrospectively from a prospectively collected database (N=5298). Eligible patients were identified from billing/coding data as having mechanisms of injury related to an aquatic setting. Patients were evaluated using standard trauma protocols. Spinal column and cord injury occurrence and differences between groups were reviewed. Personal watercrafts accounted for the majority of injuries (n=39). Cervical (33.3%), closed-head (25.7%), and thoracolumbar (21.9%) injuries accounted for the majority of injury types. The cervical spinal column and the spinal cord were at an increased risk of injury in the aquatic injury cohort (P<.0001). The current data show the high incidence of spinal column and cord injuries in this patient population relative to controls. Practitioners who care for trauma patients near an aquatic environment should be aware of the high prevalence of these injuries, with proper spinal cord preservation protocols in place to optimize outcome.

Skimboarding: An Increasingly Recognized Cause of Life-Threatening Spinal Cord Injury

“…Kane et al evaluated the epidemiology of water sports injuries at a coastal tertiary trauma center to determine its association with spinal column injuries and compare with those occurring terrestrially. They found a high incidence of vertebral column and spinal cord injuries in water sports, with a significant risk of cervical injuries [ 16 ]. Therefore, traumatic cervical injuries while practicing this type of water sport are rare.…”

Incidence and Epidemiology of Thoracolumbar Spine Fractures: WFNS Spine Committee Recommendations

“…The epidemiology of water sports injuries at a coastal area in the US has collected 105 patients. 37 Among water-based activities or recreational sport are counted swimming, surfing, boating, personal watercraft use. Personal watercrafts accounted for the majority of injuries (n = 39).…”

Aquatic Orthopaedic Injuries

“…5 Compared with individuals suffering terrestrial injuries, individuals suffering aquatic injuries have a higher rate of injury to the cervical spinal column, so cervical spine precautions should be followed when addressing the patient's airway. 6 In addition to spinal column injuries, spinal cord injuries also occur more frequently in aquatic injuries, so circulation can be compromised because of neurogenic shock. 6 As with terrestrial injuries, hypovolemic shock may result from hemorrhage by way of blunt Dr. Brophy or an immediate family member is a member of a speakers' bureau or has made paid presentations on behalf of Arthrex and serves as a board member, owner, officer, or committee member of the American Academy of Orthopaedic Surgeons and the American Orthopaedic Association.…”

“…6 In addition to spinal column injuries, spinal cord injuries also occur more frequently in aquatic injuries, so circulation can be compromised because of neurogenic shock. 6 As with terrestrial injuries, hypovolemic shock may result from hemorrhage by way of blunt Dr. Brophy or an immediate family member is a member of a speakers' bureau or has made paid presentations on behalf of Arthrex and serves as a board member, owner, officer, or committee member of the American Academy of Orthopaedic Surgeons and the American Orthopaedic Association. Neither Dr. Bernholt nor any immediate family member has received anything of value from or has stock or stock options held in a commercial company or institution related directly or indirectly to the subject of this article.…”