scholarly journals Surgery Delay Increases Length of Stay in Thoracolumbar Trauma

Neurosurgery ◽  
2019 ◽  
Vol 66 (Supplement_1) ◽  
Author(s):  
Lawrence Zeldin ◽  
Sean N Neifert ◽  
Robert J Rothrock ◽  
Ian T McNeill ◽  
Jonathan S Gal ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Spinal Injury ◽  
Specific Effect ◽  
Spinal Trauma ◽  
Spine Injury ◽  
Complication Rates ◽  
Improvement Program ◽  
Delayed Surgery ◽  
Significant Difference ◽  
Surgery Timing

Abstract INTRODUCTION The ideal timing from admission of a thoracolumbar spinal trauma patient to the start of surgery at US trauma centers remains a hotly contested area of debate. The effect of surgical latency on patient outcomes in thoracolumbar trauma remains unclear. METHODS All 2013 to 2015 thoracolumbar spinal trauma cases from the American College of Surgeons Trauma Quality Improvement Program (TQIP) were analyzed. Patients with unsurvivable spine injury, polytraumas (serious injuries in more than one bodily region), and those discharged within 24 h were excluded. Patients were classified into 3 groups by surgery timing: less than 8 h (early, N = 1699), between 8 and 24 h (normal, N = 946), and over 24 h (delayed, N = 1601). Mortality, length of stay (LOS), and complication rates were compared between groups. Demographic variables and complication rates were compared. Multivariate logistic regression was utilized to determine the specific effect of surgery timing on outcomes. RESULTS Patients with earlier surgery presented with more severe spinal trauma (P < .0001). Patients in the normal surgical timing cohort were most likely to have altered mental status (4.97% vs 3.24%, P = .05), and less likely to suffer from UTI (4.97% vs 3.24%, P = .03). Patients in the delayed cohort were older (46.2 vs 43.7 yr, P = .0003), more likely to have a longer LOS (11.3 vs 10.6 d, P = .02), return to the ICU (2.94% vs 1.29%, P = .001), experience unplanned intubation (2.06% vs 1%, P = .01) and suffer from cardiac arrest (0.53% vs 1.19%, P = .04). Upon multivariate analysis, delayed surgery was an independent risk factor for prolonged LOS (OR: 1.21, 95% CI: 0.56-1.87, P = .0003). CONCLUSION Patients with earlier surgery possessed more severe spinal injury. When adjusting for demographics and severity, no significant difference is seen in mortality between the different surgery times; however, LOS is prolonged in patients with delayed surgery.

Evaluating resident involvement and the ‘July effect’ in parotidectomy

2021 ◽  
pp. 1-6
Author(s):  
D A Benito ◽  
I Mamidi ◽  
L J Pasick ◽  
A D Sparks ◽  
C Badger ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Confidence Interval ◽  
Hospital Length Of Stay ◽  
Complication Rates ◽  
Improvement Program ◽  
Resident Participation ◽  
Increased Risk ◽  
Significant Difference ◽  
July Effect ◽  
Resident Involvement

Abstract Objective This study aimed to evaluate the effect of resident involvement and the ‘July effect’ on peri-operative complications after parotidectomy. Method The American College of Surgeons National Surgical Quality Improvement Program database was queried for parotidectomy procedures with resident involvement between 2005 and 2014. Results There were 11 733 cases were identified, of which 932 involved resident participation (7.9 per cent). Resident involvement resulted in a significantly lower reoperation rate (adjusted odds ratio, 0.18; 95 per cent confidence interval, 0.05–0.73; p = 0.02) and readmission rate (adjusted odds ratios 0.30; 95 per cent confidence interval, 0.11–0.80; p = 0.02). However, resident involvement was associated with a mean 24 minutes longer adjusted operative time and 23.5 per cent longer adjusted total hospital length of stay (respective p < 0.01). No significant difference in surgical or medical complication rates or mortality was found when comparing cases among academic quarters. Conclusion Resident participation is associated with significantly decreased reoperation and readmission rates as well as longer mean operative times and total length of stay. Resident transitions during July are not associated with increased risk of adverse peri-operative outcomes after parotidectomy.

Abstract 246: Length of Stay and Its Association With Get With the Guidelines-stroke Award Recognition

2017 ◽  
Vol 10 (suppl_3) ◽  
Author(s):  
Theresa Hamm ◽  
Angela Overton ◽  
Kathie Thomas ◽  
Renee Sednew
Keyword(s):  
Ischemic Stroke ◽  
Length Of Stay ◽  
Average Length ◽  
Hospital Costs ◽  
Stroke Patients ◽  
Improvement Program ◽  
Recommended Care ◽  
Award Winning ◽  
Significant Difference ◽  
Get With The Guidelines

Background and Objectives: The average length of stay (ALOS) provides important information regarding care efficiency and the financing of hospitals. A shorter ALOS helps to reduce hospital costs, increase capacity optimization, and improve hospital efficiency. A longer ALOS can be associated with reduced readmission rates and mortality rates. The objective of this study was to analyze the ALOS for stroke patients based on etiology subtype and Get With The Guidelines (GWTG)-Stroke award recognition. Methods: A retrospective review of the ALOS for hemorrhagic and ischemic stroke patients was conducted for the states of Illinois, Iowa, and Michigan from 99 hospitals using GWTG-Stroke from July 2014 through December 2015. Stroke subsets, GWTG award status, and ALOS were examined. Results: The national ALOS is 5.22 days for ischemic stroke, 12.75 days for subarachnoid hemorrhage (SAH), and 8.5 days for intracerebral hemorrhage (ICH). The ALOS for ischemic stroke was 4.36 days for non-award winning hospitals and 4.52 days for award winning hospitals. The ALOS for SAH was 7.51 days for non-award winning hospitals and 10.77 days for award winning hospitals. The ALOS for ICH was 18.63 days for non-award winning hospitals and 6.80 days for award winning hospitals. Further broken down, hospitals with a higher award (gold vs silver), had longer ALOS for both SAH and ICH (11.11 vs 8.72 and 7.07 vs 5.84 respectively), while there was no significant difference in ALOS for ischemic stroke. Conclusions: This study demonstrated that GWTG-Stroke award winning hospitals have a shorter ALOS for ICH and a higher ALOS for SAH than non-award winning hospitals. Those hospitals that have attained gold award status more closely align with national ALOS. Thus, hospitals that are more adherent to guideline recommended care via a quality improvement program may be more efficient when providing care, which impacts hospitals costs.

Surgical Intervention for Laryngomalacia: Age-Related Differences in Postoperative Sequelae

2020 ◽  
Vol 129 (9) ◽  
pp. 901-909
Author(s):  
Vijay A. Patel ◽  
David Adkins ◽  
Jad Ramadan ◽  
Adrian Williamson ◽  
Michele M. Carr
Keyword(s):  
Length Of Stay ◽  
Surgical Intervention ◽  
Hospital Setting ◽  
Inpatient Setting ◽  
Improvement Program ◽  
Perioperative Morbidity ◽  
Prolonged Length ◽  
Laryngeal Surgery ◽  
Age Related ◽  
Significant Difference

Objective: Identify risk factors and determine perioperative morbidity of children undergoing surgery for laryngomalacia (LM). Methods: A retrospective analysis of the multi-institutional American College of Surgeons National Surgical Quality Improvement Program-Pediatric Database (ACS-NSQIP-P) was performed to abstract patients aged <18 years with LM (ICD-10 code Q31.5) who underwent laryngeal surgery (CPT code 31541) from 2015 to 2017. Analyzed clinical variables include patient demographics, hospital setting, length of stay, medical comorbidities, postoperative complications, readmission, and reoperation. Results: A total of 491 patients were identified, 283 were male (57.6%) and 208 were female (42.4%). The mean age at time of surgery was 1.07 years (range .01-17 years). Younger patients were more likely to undergo surgery in the inpatient setting compared to their counterparts ( P < .001). Infants were more likely to have prolonged duration of days from admission to surgery ( P < .001), days from surgery to discharge ( P < .001), and total length of stay ( P<.0010). Finally, there was no significant difference between age groups with respect to 30-day general surgical complications ( P = .189), with an overall low incidence of reintubation (1.2%), readmission (3.1%), and reoperation (1.6%). Conclusion: This analysis supports laryngeal surgery as a safe surgical procedure for LM. However, younger children are more likely to undergo operative intervention in the inpatient setting, endure delays from hospital admission to surgical intervention, and experience a prolonged length of stay due to their overall medical complexity. Recognition of key factors may assist in optimizing perioperative risk assessment and promote timely procedural planning in this unique pediatric patient subpopulation.

scholarly journals EMERGENCY LAPAROTOMIES UNDER SPINAL ANESTHESIA: A RETROSPECTIVE, FACILITY BASED OBSERVATIONAL STUDY, IN KABUL, AFGHANISTAN

2021 ◽  
Vol 9 (06) ◽  
pp. 751-756
Author(s):  
Wais Farda ◽  
◽  
Ahmad Bashir Nawazish ◽  
Keyword(s):  
Length Of Stay ◽  
Observational Study ◽  
General Anesthesia ◽  
Spinal Anesthesia ◽  
Average Length ◽  
Emergency Laparotomy ◽  
Complication Rates ◽  
Abdominal Incision ◽  
Significant Difference ◽  
The Mean

Background: Laparotomy is most commonly performed under general anesthesia, but spinal anesthesia (SA) is considered an alternative to in the context of limited resources. The safety and efficacy of using SA as substitute for general anesthesia(GA) has not been explored in Afghanistan. Methodology: We conductedan observational study in the general surgery department of Isteqlal hospital in Kabul, Afghanistan on 196 adult patients undergoing emergency laparotomy under spinal anesthesia betweenApril 2018-April 2020. Results: The mean age of patients was 41.5 years (SD=19.4), the ratio of males to females was 1.9:1 and almost half (44.4%) had comorbidities. 21% were classified as ASA grade III and IV with a similar pattern among males and females. A total of 11 (5.6%) cases were converted to GA. Conversion pattern to GA was similar amongmales and females(P=0.71), ASA grade (P=0.432) and age group (P=0.642). The mean length of stay after operation was 6.5 days (SD=4.1). 32 (16.3%) patients suffered SA complications with no significant difference in terms of sex (P=0.134). Hypotension and headache accounted for 97% of complications. Complication rates were similar in terms of intervertebral level (P=0.349), type of abdominal incision (P>0.1) and average length of stay (P=0.156). 18 patients (9.2%) died due to MOF, sepsis, respiratory failure, thromboembolism and cardiogenic shock. Conclusion: Spinal anesthesia is considered a safe and effective anesthesia for emergency laparotomies, even for those with comorbidities. Based on our findings we would recommend spinal anesthesia as an alternative to general anesthesiain emergency laparotomy in Afghanistan.

scholarly journals 931 Deep Inferior Epigastric Perforator (DIEP) Flap: Impact of Early Drain Removal on Seroma Formation Rate and Duration of Inpatient Stay

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
K Grigg ◽  
R Clancy ◽  
C Lewis ◽  
P Jackson
Keyword(s):  
Length Of Stay ◽  
Enhanced Recovery ◽  
Formation Rate ◽  
Seroma Formation ◽  
Diep Flap ◽  
Complication Rates ◽  
Post Surgery ◽  
Drain Removal ◽  
Significant Difference ◽  
The Mean

Abstract Aim Donor site seroma can follow deep inferior epigastric flap (DIEP) harvest. Post-surgery gradient technology (GTC) garments are worn by DIEP patients postoperatively following drain removal to reduce seroma formation. Early drain removal was considered a contributing factor to increased seroma formation rate. From June 2018 drain removal regardless of output was instigated at day two post-surgery. Prior to this, drains were removed when less than 30mls over 24 hours. We aim to assess the seroma rate post DIEP harvest with early drain removal. Method Retrospective review of prospectively managed database between June 2018 to May 2020. Surgical complications and length of stay in hospital were recorded. Results 200 patients underwent DIEP flap breast reconstruction. The mean age of patients was 52 years (range 28-73). There was no significant difference in seroma complication rate between those who had drains removed on day 3 compared with day 2 ((1.02% (1/98) vs. (0.98% (1/102); p = 1). The mean length of stay in hospital for the 1st cohort was 3.86 days and for the 2nd cohort was 3.23 days. There were no complications related to drain removal. Conclusions Our data suggests that drain removal after 2 days postoperatively with DIEP reconstruction does not affect seroma complication rates. Moreover, it leads to a shorter hospital stay. These conclusions are in keeping with enhanced recovery protocols and an early drain removal surgical process could be advised.

Perioperative complication rates following neoadjuvant therapy in pancreatic adenocarcinoma.

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 688-688
Author(s):  
Christopher R. Deig ◽  
Blake Beneville ◽  
Amy Liu ◽  
Aasheesh Kanwar ◽  
Alison Grossblatt-Wait ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Neoadjuvant Therapy ◽  
Pancreatic Adenocarcinoma ◽  
Locally Advanced ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Complication Rates ◽  
Significant Difference ◽  
Perioperative Complication ◽  
The Impact

688 Background: Whether upfront resection or total neoadjuvant therapy is superior for the treatment of potentially resectable pancreatic adenocarcinoma (PDAC) remains controversial. The impact of neoadjuvant treatment on major perioperative complication rates for patients (pts) undergoing resection for PDAC is commonly debated. We hypothesized that rates would be comparable among patients receiving neoadjuvant chemoradiation (neo-CRT), neoadjuvant chemotherapy alone (neo-CHT), or upfront surgery. Methods: This is a retrospective study of 208 pts with PDAC who underwent resection within a multidisciplinary pancreatico-biliary program at an academic tertiary referral center between 2011-2018. Data were abstracted from the medical record, an institutional cancer registry and NSQIP databases. Outcomes were assessed using χ2, Fisher’s exact test and two-tailed Student’s t-tests. Results: 208 pts were identified: 33 locally advanced, borderline or upfront resectable pts underwent neo-CRT, 35 borderline or resectable pts underwent neoadjuvant-CHT, and 140 resectable pts did not undergo neoadjuvant therapy. There were no statistically significant differences in major perioperative complication rates between groups. Overall rates were 36.4%, 34.3%, and 26.4% for pts who underwent neo-CRT, neo-CHT alone, or upfront resection, respectively (p = 0.38). No significant difference were observed in complication rates (35.3% v. 26.4%; p = 0.19) or median hospital length of stay (10 days v. 10 days; p = 0.87) in pts who received any neoadjuvant therapy versus upfront resection. There were two perioperative deaths in the neo-CRT group (6.1%), zero in the neo-CHT group, and four in the upfront resection group (2.9%); p = 0.22. Conclusions: There were no significant differences in major perioperative complication rates, hospital length of stay, or post-operative mortality in pts who underwent neoadjuvant therapy (neo-CRT or neo-CHT alone) versus upfront surgery. Notably, neo-CRT had comparable perioperative complication rates to neo-CHT alone, which suggests neoadjuvant radiation therapy may not pose additional surgical risk.

Abstract 249: The Costs and Acute Outcomes Following Pulmonary Vein Isolation for Atrial Fibrillation in Elderly Patients a Comparison Between Cryoballoon and Radiofrequency Ablation

Circulation ◽  
2019 ◽  
Vol 140 (Suppl_2) ◽  
Author(s):  
Chao-Feng Chen
Keyword(s):  
Atrial Fibrillation ◽  
Length Of Stay ◽  
Elderly Patients ◽  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Left Atrial ◽  
Dwell Time ◽  
Complication Rates ◽  
Rf Ablation ◽  
Significant Difference

Backgroup: Limited comparative data exist regarding catheter ablation (CA) of atrial fibrillation (AF) using second-generation cryoballoon (CB-2) ablation versus radiofrequency (RF) ablation in elderly patients (>75 years ). This study aims to compare the costs and periprocedural outcomes in elderly patients using these two strategies. Methods: Elderly patients (>75years) with symptomatic drug-refractory AF were included in the study. Pulmonary vein isolation (PVI) was performed in all patients by CB or RF. The costs and periprocedural outcomes of the two strategies are compared using SPSS 22. Results: 324 elderly patients with symptomatic drug-refractory paroxysmal/short-lasting persistent AF received PVI using RF (n=176) and CB-2 (n=148) from September 2016 to April 2019. The CB-2 was associated with shorter procedure duration and left atrial dwell time (128.9±18.3 vs. 152.8±18.9 minutes, P<0.001; 89.4±18.4 vs. 101.9± 22.2minutes, P <0.001), but greater fluoroscopy utilization (24.3±10.9 vs. 19.2±7.5 minutes, P <0.001). Periprocedural complications occurred in 3.4% (CB-2) and 9.1% (RF) of patients (P=0.037). There was no significant difference between 2 groups for AF/atrial tachycardia (AT) recurrence until discharge (16.2 vs. 18.7%, P = 0.552). The length of stay after ablation was shorter, but the costs were greater in the CB-2 group ( P <0.001). Conclusions: Both CB-2 and RF ablation appear to be safe and effective for AF in elderly patients (>75 years). In addition, CB-2 is associated with shorter procedure time, left atrial dwell time, and length of stay after ablation, as well as lower complication rates, but its costs and fluoroscopy time are greater than those of the RF group.

scholarly journals Two-level corpectomy versus three-level discectomy for cervical spondylotic myelopathy: a comparison of perioperative, radiographic, and clinical outcomes

2015 ◽  
Vol 23 (3) ◽  
pp. 280-289 ◽  
Author(s):  
Darryl Lau ◽  
Dean Chou ◽  
Praveen V. Mummaneni
Keyword(s):  
Length Of Stay ◽  
Neck Pain ◽  
Cobb Angle ◽  
Clinical Outcomes ◽  
Subgroup Analysis ◽  
Cervical Spondylotic Myelopathy ◽  
Complication Rates ◽  
Second Stage ◽  
Estimated Blood Loss ◽  
Significant Difference

OBJECT In the treatment of cervical spondylotic myelopathy (CSM), anterior cervical corpectomy and fusion (ACCF) and anterior cervical discectomy and fusion (ACDF) are effective decompressive techniques. It remains to be determined whether ACCF and ACDF offer equivalent outcomes for multilevel CSM. In this study, the authors compared perioperative, radiographic, and clinical outcomes between 2-level ACCF and 3-level ACDF. METHODS Between 2006 and 2012, all patients at the authors' hospital who underwent 2-level ACCF or 3-level ACDF performed by 1 of 2 surgeons were identified. Primary outcomes of interest were sagittal Cobb angle, adjacent-segment disease (ASD) requiring surgery, neck pain measured by visual analog scale (VAS), and Nurick score. Secondary outcomes of interest included estimated blood loss (EBL), length of stay, perioperative complications, and radiographic pseudarthrosis rate. Chi-square tests and 2-tailed Student t-tests were used to compare the 2 groups. A subgroup analysis of patients without posterior spinal fusion (PSF) was also performed. RESULTS Twenty patients underwent 2-level ACCF, and 35 patients underwent 3-level ACDF during a 6-year period. Preoperative Nurick scores were higher in the ACCF group (2.1 vs 1.1, p = 0.014), and more patients underwent PSF in the 2-level ACCF group compared with patients in the 3-level ACDF group (60.0% vs 17.1%, p = 0.001). Otherwise there were no significant differences in demographics, comorbidities, and baseline clinical parameters between the 2 groups. Two-level ACCF was associated with significantly higher EBL compared with 3-level ACDF for the anterior stage of surgery (382.2 ml vs 117.9 ml, p < 0.001). Two-level ACCF was also associated with a longer hospital stay compared with 3-level ACDF (7.2 days vs 4.9 days, p = 0.048), but a subgroup comparison of patients without PSF showed no significant difference in length of stay (3.1 days vs 4.4 days for 2-level ACCF vs 3-level ACDF, respectively; p = 0.267). Similarly, there was a trend toward more complications in the 2-level ACCF group (20.0%) than the 3-level ACDF group (5.7%; p = 0.102), but a subgroup analysis that excluded those who had second-stage PSF no longer showed the same trend (2-level ACCF, 0.0% vs 3-level ACDF, 3.4%; p = 0.594). There were no significant differences between the ACCF group and the ACDF group in terms of postoperative sagittal Cobb angle (7.2° vs 12.1°, p = 0.173), operative ASD (6.3% vs 3.6%, p = 0.682), and radiographic pseudarthrosis rate (6.3% vs 7.1%, p = 0.909). Both groups had similar improvement in mean VAS neck pain scores (3.4 vs 3.2 for ACCF vs ACDF, respectively; p = 0.860) and Nurick scores (0.8 vs 0.7, p = 0.925). CONCLUSIONS Two-level ACCF was associated with greater EBL and longer hospital stays when patients underwent a second-stage PSF. However, the length of stay was similar when patients underwent anterior-only decompression with either 2-level ACCF or 3-level ACDF. Furthermore, perioperative complication rates were similar in the 2 groups when patients underwent anterior decompression without PSF. Both groups obtained similar postoperative cervical lordosis, operative ASD rates, radiographic pseudarthrosis rates, neurological improvement, and pain relief.

scholarly journals Supratentorial and Infratentorial Approaches to Pineal Surgery: A Database Analysis

2018 ◽  
Vol 80 (04) ◽  
pp. 364-370
Author(s):  
David M. Rosenberg ◽  
Brett W. Geever ◽  
Akash S. Patel ◽  
Anisse N. Chaker ◽  
Abhiraj D. Bhimani ◽  
...  
Keyword(s):  
Pineal Gland ◽  
Clinical Decision Making ◽  
Tumor Resection ◽  
Postoperative Outcomes ◽  
Complication Rates ◽  
Database Analysis ◽  
Improvement Program ◽  
Multicenter Studies ◽  
Patient Demographics ◽  
Significant Difference

Objectives Neoplasms involving the pineal gland are rare. When they do occur, tumor resection is anatomically challenging and is traditionally addressed by either a supratentorial or an infratentorial approach. To date, no large, multicenter studies have been performed that systematically analyze outcomes comparing these two approaches. This study aimed to evaluate outcomes for patients undergoing pineal neoplasm resection, comparing supratentorial and infratentorial approaches. Design Retrospective database review. Setting Multi-institutional database. Participants From 2005 to 2016, 60 patients were identified, with 13 undergoing a supratentorial approach and 47 undergoing an infratentorial approach. Main Outcome Measures Patient demographics, comorbidities, and 30-day postoperative outcomes were investigated using the American College of Surgeons National Surgical Quality Improvement Program database. Demographics, readmission, reoperation, and complication rates were analyzed and compared with previous studies. Results Patient demographics were similar between these two groups. The overall complication rates for the supratentorial and infratentorial approaches were 30.8 and 17%, respectively, and the difference was not statistically significant. The most common medical complications encountered were respiratory and hematological. Conclusion As the first multi-institutional database analysis of approaches to the pineal gland, this study provides an analysis of patient demographics, comorbidities, and postoperative complications. After controlling for preoperative risk factors and demographic characteristics, no statistically significant differences in postoperative outcomes were found between infratentorial and supratentorial approaches. The mean readmission, reoperation, and complication rates were found to be 2.1, 8.3, and 20%, respectively. The lack of significant difference between approaches suggests that clinical decision-making should depend upon anatomical considerations and physician preference, although the complications illustrated here may provide some preoperative guidance.

Helmet use and reduction in skull fractures in skiers and snowboarders admitted to the hospital

2011 ◽  
Vol 7 (3) ◽  
pp. 268-271 ◽  
Author(s):  
Anand I. Rughani ◽  
Chih-Ta Lin ◽  
Wiliam J. Ares ◽  
Deborah A. Cushing ◽  
Michael A. Horgan ◽  
...  
Keyword(s):  
Head Injury ◽  
Length Of Stay ◽  
Skull Fracture ◽  
Ct Scans ◽  
Spine Injury ◽  
Intracranial Injury ◽  
Helmet Use ◽  
Number Of Patients ◽  
Significant Difference ◽  
Secondary Outcomes

Object Helmet use has been associated with fewer hospital visits among injured skiers and snowboarders, but there remains no evidence that helmets alter the intracranial injury patterns. The authors hypothesized that helmet use among skiers and snowboarders reduces the incidence of head injury as defined by findings on head CT scans. Methods The authors performed a retrospective review of head-injured skiers and snowboarders at 2 Level I trauma centers in New England over a 6-year period. The primary outcome of interest was intracranial injury evident on CT scans. Secondary outcomes included the following: need for a neurosurgical procedure, presence of spine injury, need for ICU admission, length of stay, discharge location, and death. Results Of the 57 children identified who sustained a head injury while skiing or snowboarding, 33.3% were wearing a helmet at the time of injury. Of the helmeted patients, 5.3% sustained a calvarial fracture compared with 36.8% of the unhelmeted patients (p = 0.009). Although there was a favorable trend, there was no significant difference in the incidence of epidural hematoma, subdural hematoma, intraparenchymal hemorrhage, subarachnoid hemorrhage, or contusion in helmeted and unhelmeted patients. With regard to secondary outcomes, there were no significant differences between the 2 groups in percentage of patients requiring neurosurgical intervention, percentage requiring admission to an ICU, total length of stay, or percentage discharged home. There was no difference in the incidence of cervical spine injury. There was 1 death in an unhelmeted patient, and there were no deaths among helmeted patients. Conclusions Among hospitalized children who sustained a head injury while skiing or snowboarding, a significantly lower number of patients suffered a skull fracture if they were wearing helmets at the time of the injury.

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