WMJ Vol 121 Issue 4: Analysis and Incidence Calculation of Snowmobile Injuries Identified in a Rural Wisconsin Health Care System Over Five Years


Introduction: Current estimates of snowmobile-related injuries are largely based on inpatient data from trauma centers. These centers care for severely injured patients and may not capture treatment information and outcomes for minor snowmobile-related injuries, therefore underestimating their volume and overestimating patient acuity.

Methods: Medically attended snowmobile injuries were identified retrospectively from inpatient and outpatient records from a health system in north-central Wisconsin using a hierarchical method of International Classification of Diseases external cause codes and text searches for key words. Manual reviews of the medical record collected information on patient characteristics, accident details, and clinical information. Descriptive analyses, comparisons between hospital admitted and nonadmitted cases, and calculations of seasonal incidence rates were conducted.

Results: From November 1, 2013, through April 30, 2018, there were 1013 snowmobile-related injuries, with 264 (26%) cases hospitalized and 749 (74%) treated as outpatients. Text search alone identified 61% of all incidents and about a quarter (26%) of hospitalized incidents. Inpatients were older and a higher percentage wore helmets, sustained multisystem trauma, sustained more fractures, more organ injuries, and had higher need for surgery and intensive care. Mortality was 1%. The average annual injury incidence rate was 313 per 100,000 snowmobiles registered.

Conclusions: Currently available studies of snowmobile-related injuries have underestimated their number and burden. Studies combining datasets from health systems in the state and statewide mortality records for cases who died prior to care could elucidate the full statewide impact of snowmobile-related injuries in Wisconsin, leading to better assessment of prevention efforts and staffing in rural trauma systems.

Intended Audience

The target audience for this journal-based activity is healthcare providers caring for the people and communities of Wisconsin and beyond.

Learning Objectives

As a result of this journal-based activity, learners, as members of the healthcare team, will be able to:

  1. Explain a challenge of accurate calculation of the incidence of snowmobile-related injuries.
  2. Elaborate on the result of a study that analyzed medically attended snowmobile injuries identified retrospectively in inpatient and outpatient records from a rural Wisconsin health care system
  3. Discuss how an approach proposed by the authors could be enacted in other health care organizations to enhance injury reporting and surveillance of snowmobile-related injuries to better inform prevention efforts and staff­ing of trauma care.
Course summary
Available credit: 
  • 1.00 AMA PRA Category 1 Credit
  • 1.00 University of Wisconsin–Madison Continuing Education Hours
    • 1.00 Approved for AMA PRA Category 1 Credit™
Registration opens: 
Course expires: 


It is the policy of the University of Wisconsin–Madison Interprofessional Continuing Education Partnership (ICEP) to identify, mitigate and disclose all relevant financial relationships with ineligible companies* held by the  speakers/presenters, authors, planners, and other persons who may influence content of this accredited continuing education (CE).  In addition, speakers, presenters and authors must disclose any planned discussion of unlabeled/unapproved uses of drugs or devices during their presentation.

For this accredited continuing education activity all relevant financial relationships have been mitigated and detailed disclosures are listed below.

Name of IndividualIndividual's Role in Activity

Financial Relationship Disclosure

Discussion of
Uses of Drugs/Devices
in Presentation?

Shezad Baloch, MAAccreditation SpecialistNo relevant relationships with ineligible companies to discloseNo
Jennifer P. King, MPHAuthorNo relevant relationships with ineligible companies to discloseNo
Oluwatosin Olaiya, MBChB, MScAuthorNo relevant relationships with ineligible companies to discloseNo
Daniel C. Cullinane, MDAuthorNo relevant relationships with ineligible companies to discloseNo
Amy E. Liepert, MDReviewerNo relevant relationships with ineligible companies to discloseNo
Paul D. Creswell, PhDReviewerNo relevant relationships with ineligible companies to discloseNo
Sarina B. Schrager, MDEditorNo relevant relationships with ineligible companies to discloseNo

*Ineligible companies are those whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on, patients.

The ACCME does not consider providers of clinical services directly to patients to be ineligible companies.

The table below reflects unmitigated data. Please see the table above for final mitigated disclosure information.

Discloser List CME Internal Report


Accreditation Statement

In support of improving patient care, this activity has been planned and implemented by the University of Wisconsin–Madison ICEP and the Wisconsin Medical Journal.  The University of Wisconsin–Madison ICEP is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

Credit Designation Statements

American Medical Association (AMA)

The University of Wisconsin–Madison ICEP designates this journal-based CE activity for a maximum of 1.0 AMA PRA Category 1 Credit™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Continuing Education Units

The University of Wisconsin–Madison ICEP, as a member of the University Professional & Continuing Education Association (UPCEA), authorizes this program for 0.1 continuing education units (CEUs) or 1 hour.

Available Credit

  • 1.00 AMA PRA Category 1 Credit
  • 1.00 University of Wisconsin–Madison Continuing Education Hours
    • 1.00 Approved for AMA PRA Category 1 Credit™

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