Burial duration, depth and air pocket explain avalanche survival patterns in Austria and Switzerland

Resuscitation. 2016 Aug:105:173-6. doi: 10.1016/j.resuscitation.2016.06.001. Epub 2016 Jun 14.

Abstract

Aim: To calculate the first Austrian avalanche survival curve and update a Swiss survival curve to explore survival patterns in the Alps.

Methods: Avalanche accidents occurring between 2005/06 and 2012/13 in Austria and Switzerland were collected. Completely buried victims (i.e. burial of the head and chest) in open terrain with known outcome (survived or not survived) were included in the analysis. Extrication and survival curves were calculated using the Turnbull algorithm, as in previous studies.

Results: 633 of the 796 completely buried victims were included (Austria n=333, Switzerland n=300). Overall survival was 56% (Austria 59%; Switzerland 52%; p=0.065). Time to extrication was shorter in Austria for victims buried ≤60min (p<0.001). The survival curves were similar and showed a rapid initial drop in survival probability and a second drop to 25-28% survival probability after burial duration of ca. 35min, where an inflection point exists and the curve levels off. In a logistic regression analysis, both duration of burial and burial depth had an independent effect on survival. Victims with an air pocket were more likely to survive, especially if buried >15min.

Conclusion: The survival curves resembled those previously published and support the idea that underlying survival patterns are reproducible. The results are in accordance with current recommendations for management of avalanche victims and serve as a reminder that expedient companion rescue within a few minutes is critical for survival. An air pocket was shown to be a positive prognostic factor for survival.

Keywords: Asphyxia; Avalanche; Burial depth; Survival curve; Survival probability.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Algorithms
  • Asphyxia / mortality*
  • Asphyxia / prevention & control
  • Austria / epidemiology
  • Avalanches / mortality*
  • Disasters / statistics & numerical data
  • Humans
  • Logistic Models
  • Rescue Work / methods
  • Rescue Work / statistics & numerical data*
  • Retrospective Studies
  • Statistics, Nonparametric
  • Survival Analysis
  • Switzerland / epidemiology
  • Time Factors