Head and Neck Injuries from Rock Climbing: A Query of the National Electronic Injury Surveillance System

Abstract

Objective: We describe the incidence and characteristics of patients with head and neck injuries from rock climbing who present to United States emergency departments and evaluate predictors of hospitalization. Methods: The National Electronic Injury Surveillance System (NEISS) database was queried for rock climbing injuries to the head, face, mouth, neck, and ear under product code “mountain climbing” from the years 2009 to 2018. Demographics, injury characteristics, and disposition data were reviewed. Data were evaluated using chi-square analysis with Cochran-Mantel-Haenszal odds ratios (ORs). Results: An estimated 5067 patients (from 129 raw NEISS case numbers) suffered head and neck injuries from rock climbing nationally from 2009 to 2018. Concussion/closed head injury was the most common injury (44%), followed by laceration (23%), soft tissue injury (15%), neck strain/sprain (6%), skull fracture (3%), facial fracture (3%), intracranial hemorrhage (3%), cervical spine fracture (2%), unspecified facial trauma (1%), and dental trauma (0.3%). Males more frequently suffered lacerations (OR 1.6), soft tissue injuries (OR 23.3), cervical spine fractures (OR 336.7), intracranial hemorrhage (OR 582.0), and skull fractures (OR 6.2) than females. Compared to shorter falls, falls over 20 ft were more commonly associated with laceration (OR 2.0), soft tissue injury (OR 3.5), facial fracture (OR 7.5), dental trauma (OR 6.6), intracranial hemorrhage (OR 951.8), skull fracture (OR 81.2), and hospitalization (OR 3.8). Injuries associated with hospitalization included facial fracture (OR 23.7), cervical spine fracture (OR 24.6), intracranial hemorrhage (OR 2210.2), and skull fracture (OR 9.8). Conclusions: Concussions and facial lacerations are the most common head and neck injuries from rock climbing. Males more commonly suffer severe injuries. Falls over 20 ft are associated with more severe injuries and an increased likelihood of hospitalization.