Cohort Study on the Association Between Helmet Use and Traumatic Brain Injury in Snowboarders From a Swiss Tertiary Trauma Center.

Hasler, Rebecca Maria; Baschera, Dominik; Taugwalder, David; Exadaktylos, Aristomenis; Raabe, Andreas (2015). Cohort Study on the Association Between Helmet Use and Traumatic Brain Injury in Snowboarders From a Swiss Tertiary Trauma Center. World neurosurgery, 84(3), pp. 805-812. Elsevier 10.1016/j.wneu.2015.05.016

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Since the introduction of helmets in winter sports there is on-going debate on whether they decrease traumatic brain injuries (TBI).


This cohort study included 117 adult (≥ 16 years) snowboarders with TBI admitted to a level I alpine trauma center in Switzerland between 2000/2001 and 2010/2011. The primary objective was to examine the association between helmet use and moderate-to-severe TBI. Secondary objectives were to describe the epidemiology of TBI during the past decade in relation to increased helmet use.


Of 691 injured snowboarders evaluated, 117 (17%) suffered TBI. Sixty-six percent were men (median age, 23 years). Two percent of accidents were fatal. Ninety-two percent of patients sustained minor, 1% moderate, and 7% severe TBI according to the Glasgow coma scale. Pathologic computed tomography findings were present in 16% of patients, 26% of which required surgery. Eighty-three percent of TBIs occurred while riding on-slope. There was no trend in the TBI rate during the studied period, although helmet use increased from 10% to 69%. Comparing patients with and without a helmet showed no significant difference in odds ratios for the severity of TBI. However, of the 5 patients requiring surgery only 1 was wearing a helmet. Off-piste compared with on-slope snowboarders showed an odds ratio of 26.5 (P = 0.003) for sustaining a moderate-to-severe TBI.


Despite increased helmet use we found no decrease in TBI among snowboarders. The possibility of TBI despite helmet use and the dangers of riding off-piste should be a focus of future prevention programs.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurosurgery
04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > University Emergency Center

UniBE Contributor:

Hasler, Rebecca Maria, Baschera, Dominik, Exadaktylos, Aristomenis, Raabe, Andreas


600 Technology > 610 Medicine & health








Romana Saredi

Date Deposited:

12 Apr 2016 08:32

Last Modified:

05 Dec 2022 14:53

Publisher DOI:


PubMed ID:


Uncontrolled Keywords:

Helmet; Snowboarding; TBI; Traumatic brain injury




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