Nationwide trends and injury patterns associated with ski and snowboard-related hospitalizations

Skiing and snowboarding are popular winter sports in the United States that attract millions of participants annually. Despite advancements in protective equipment and adoption, contemporary national data on trends, injury patterns, and resource utilization associated with ski and snowboard-related hospitalizations remains limited.

Nonelective hospitalizations for ski and snowboard-related injuries were identified using the 2016-2022 National Inpatient Sample. Trends in hospitalization incidence and costs were assessed, alongside patient demographics, hospital characteristics, and injury patterns.

Of 13,105 cases, 79.5% comprised the Ski cohort, while 20.5% comprised the Snowboard cohort. From 2016 to 2022, the incidence of ski-related hospitalizations increased from 1235 to 1905 cases (p = 0.37; p = 0.03 excluding Covid-19 years), while the incidence of snowboard-related hospitalizations increased from 245 to 455 cases (p = 0.13; p = 0.09 excluding Covid-19 years). Annual costs rose from $29.4 million to $52.5 million for ski-related hospitalizations (p = 0.04), and $3.61 million to $9.20 million for snowboard-related hospitalizations (p = 0.07). Compared to snowboarders, skiers were older and were more commonly treated at hospitals in rural regions. Across both cohorts, the census divisions with the highest total inpatient costs were the Mountain division ($176 million) followed by the Pacific division ($63.8 million) and the New England division ($26.2 million). Following risk-adjustment, snowboarders were more likely to sustain a traumatic brain injury (Adjusted Odds Ratio [AOR] 1.36, 95% Confidence Interval [CI] 1.04-1.78) as well as fractures to the humerus (AOR 2.32, 95%Cl 1.48-3.63) and radius/ulna (AOR 2.52, 95%CI 1.56-4.07) in reference to skiers. However, snowboarders were less likely to experience femur (AOR 0.37, 95%CI 0.25-0.54) and tibia/fibula fractures (AOR 0.22, 95%CI 0.16-0.32). Moreover, snowboarders faced shorter length of stay (-0.54 days, 95%CI -0.81-(-0.27)) and reduced hospitalization costs (-$3500, 95%CI -5,500-(-1500)) compared to skiers.

Ski and snowboard-related hospitalizations and associated costs rose from 2016 to 2022. Understanding contemporary trends and injury patterns can help inform targeted prevention. Potential strategies include promoting helmet use, equipment maintenance, and enhanced care in rural regions, all of which may help reduce injury risk and healthcare costs.