Patterns and predictors of serious surf-related injuries in Hawaii

Introduction Surfing is a popular leisure activity with inherent risk of injury that many participants fail to mitigate. There is a paucity of literature reporting severe surf-related trauma and associated risk factors. Methods A retrospective observational study of registry data from Honolulu's main trauma center assessing surf-related injuries and risk factors for severe injury was performed between January 1, 2014 and December 31, 2018. Results Spine (35.1%), face (17.5%), and head (12.3%) injuries were the most common injuries identified in this cohort. A number of predictors for severe injury as well as serious spine injury were identified. Major risk factors for severe injury and serious spine injury included location of injury on Maui (Severe injury: OR 6.79, 95%CI 1.43-40.35, p = 0.0217; serious spine injury: OR 7.27, 95%CI 1.39-58.24, p = 0.0308) and being from one of the 48 contiguous states (severe injury: OR 3.33, 95%CI 1.10-10.98, p = 0.0388; serious spine injury: OR 2.95, 95%CI 1.08-8.46, p = 0.0379). Conclusion Understanding the nature of surf-related injuries and who is at risk can help to inform safety interventions that may prevent severe, sometimes irreversible injury. Efforts should be made to increase public awareness to the potential risk of surf-related activities.