An analysis of skiing and snowboarding injuries on Utah slopes.

BACKGROUND: Injuries sustained while skiing or snowboarding are commonly encountered in emergency departments near winter resorts. The purpose of this study is to identify and compare the types of injuries likely to be found in the skier or snowboarder patient. An additional goal of this study is to provide a description of the demographics and hospitalizations for these patients. METHODS: A retrospective cohort study consisting of patients treated for skiing- or snowboarding-related injuries was performed at the University of Utah Medical center. All emergency department visits were captured: walk-ins and emergency medical service transports (ground and air). Seven hundred ninety-four skiing and 348 snowboarding-related cases were identified for a total of 1,142. Cases that occurred within 2001/2002 to 2005/2006 seasons were included in the study. Injuries were classified according to the International Classification of Diseases-9th Revision system and categorized by body location and specific type of injury. Outputs for this study include the chi test using the skiers as the control group due to size, with risk odds ratios comparing snowboarders to skiers. A p value of <0.05 was considered significant. RESULTS: Patients injured while skiing and snowboarding were predominantly men, representing 70.0% of injured skiers and 87.6% of injured snowboarders. The mean age for skiers was 41 (SD = 16), whereas the mean age for snowboarders was 23 (SD = 8). High percentages of patients among both groups had suffered injury to the head, which was more common in snowboarders when compared with skiers (27.3% vs. 20.4%, p = 0.010). Despite this fact, skiers tended to have slightly higher percentages of Glasgow Coma Scores in the moderate to severe range and accounted for all fatalities secondary to head injury (8 of 9 fatalities). The single snowboarder fatality was not caused by head injury but rather pneumothorax. Injuries to the head that were more common in skiers were fractures to the facial bones (5.2% vs. 1.4%, p = 0.003) and facial lacerations (5.8% vs. 2.9%, p = 0.035). Skiers were more likely to sustain injuries to the lower extremities (51.3% vs. 26.2%, p < 0.001), whereas snowboarders commonly had injuries to the abdomen and its organs (22.4% vs. 11.2%, p < 0.001). A considerable amount of snowboarders had injuries to the spleen (11.2%), liver (3.7%), and kidney (2.2%). Injuries to the spine were common in both groups but more in snowboarders (20.7% vs. 13.4%, p = 0.002). On an average, skiers spent 3.4 days in the hospital (SD = 3), a day longer than snowboarders who averaged 2.4 (SD = 2). Skiers were more frequently admitted to the floor or the operating room, whereas snowboarders were more often admitted to the intensive care unit. CONCLUSION: Patients injured while skiing or snowboarding are predominantly men, and participants in both sports are at risk for sustaining major injuries. The types of injuries differ and are dependent on the sport. An awareness of these differences will help skiers and snowboarders minimize their risk of injury by altering their riding strategies and by choosing appropriate protective equipment.

A deprotonated intermediate in the amide methanolysis reaction of an N4O-ligated mononuclear zinc complex.

Treatment of [(ppbpa)Zn](ClO4)2 (1(ClO4)2, ppbpa = N-((6-(pivaloylamido)-2-pyridyl)methyl)-N,N-bis((2-pyridyl)methyl)amine) with 1 equiv of Me(4)NOH.5H(2)O in methanol-acetonitrile solution results within minutes in the stoichiometric formation of a complex having a deprotonated amide, [(ppbpa-)Zn]ClO4 (3). Complex 3 has been characterized by 1H and 13C NMR, FTIR, and elemental analysis. Notably, upfield shifts of specific 1H NMR resonances of the amide-appended pyridyl moiety in 3, versus those found for 1(ClO4)2, indicate delocalization of the anionic charge within the amide-appended pyridyl donor of this complex. Heating of analytically pure 3 in methanol-acetonitrile results in amide alcoholysis. Overall, this alcoholysis reaction is second-order, with a first-order dependence on both 3 and methanol. Analysis of the rate of decay of 3 as a function of temperature yielded activation parameters consistent with an intramolecular amide cleavage process (DeltaH++ = 15.0(3) kcal/mol, DeltaS++ = -33(1) eu). A possible reaction mechanism for amide alcoholysis is presented which involves reaction of the deprotonated amide intermediate 3 with methanol to produce a Lewis activated-type structure from which amide cleavage may be initiated. Additional support for this mechanistic pathway has been obtained through examination of the analogous ethanolysis reaction and via evaluation of the effect of varying steric hindrance near the amide carbonyl unit.