OBJECTIVE: There are limited data regarding concussion among youth skiers and 
snowboarders. The objective of this study was to examine the frequency of 
concussion among helmeted and unhelmeted youth skiers and snowboarders 
presenting to trauma centers.
METHODS: Subjects 18 years or younger with a ski- or snowboard-related injury 
were studied using data from the National Trauma Data Bank from 2009 to 2010. We 
further selected those with head/neck injuries and stratified based on helmet 
status. Concussive injuries were identified from International Classification of 
Diseases, 9th Revision codes. Severity analysis was based on the Glasgow Coma 
Scale and Injury Severity Score.
RESULTS: A total of 1001 subjects met inclusion criteria with 678 subjects 
having documented helmet status. Subjects 12 years or younger were more likely 
to use helmets compared to 13-18 year-olds (odds ratio, 2.21; 95% confidence 
interval [95% CI], 1.52-3.21). Skiers were more likely to use helmets compared 
to snowboarders (odds ratios, 1.60; 95% CI, 1.16-2.19). Snowboarders had a 
greater likelihood of concussion (estimated-β, 2.1; 95% CI, 1.48-2.85) after 
adjusting for helmet status and age. There was no significant difference in the 
frequency of concussion among helmeted compared to unhelmeted subjects. Imputing 
missing values for helmets status had no effect on outcome for concussion. We 
found no difference in injury severity among helmeted compared to unhelmeted 
subjects.
CONCLUSIONS: Among youth skiers and snowboarders who present to trauma centers 
with a head injury, the likelihood of that injury involving a concussion was not 
associated with helmet use.