Epidemiology and severity of mountain rescue missions in Poland: a retrospective study of 9,477 patients rescued by the Tatra Mountain Rescue Service

BACKGROUND: Mountain activities have become increasingly popular in recent years, leading to a growing number of mountain rescue missions. Despite this trend, detailed epidemiological analyses of mountain accidents in the Polish Tatra Mountains are lacking. The aim of this study was to describe the epidemiology of mountain rescue missions in the Polish Tatra Mountains, with particular emphasis on the severity of the case mix of injuries and illnesses and their implications for rescue response. METHODS: A retrospective analysis of prospectively collected data from the Tatra Mountain Rescue Service (TOPR) covering the period of 2015-2024 was conducted. Demographic, epidemiological, and operational data were extracted from the electronic rescue registry. The severity of the patient's condition was classified using the National Advisory Committee for Aeronautics (NACA) score. The population at risk was estimated on the basis of the number of ticket entries to Tatra National Park during the study period. Seasonal differences in rescue incidence and severity were analysed, and absolute risk increase (ARI) and number needed to harm (NNH) were calculated. RESULTS: A total of 9,477 patients were included in the final analysis. The median age of the rescued individuals was 36 years (IQR 25-48); 48% (n = 4,539) were women, and 10% (n = 998) were minors. The median NACA score was 2 (IQR, 0-3), while 38% of the patients were classified as having a NACA score ≥ 3. Deaths occurred in 2% of the rescue missions. The median duration of rescue missions was 1.75 h (1.25-2.75). For every 100,000 visitors to the Tatra National Park, approximately 24 rescue missions were performed, including one involving severe injury or illness (NACA ≥ 4). Severe cases were significantly more frequent during the winter season (6.3% vs. 4.7%; p = 0.001). Helicopters were used in approximately one-third of the missions, and their use was correlated with higher NACA scores. CONCLUSION: Mountain rescue missions in the Polish Tatra Mountains were associated with seasonal patterns of mountain activities and the number of visitors to Tatra National Park. Systematic assessment of a patient's severity using the NACA score may support decision-making and resource allocation in mountain rescue. Epidemiological analyses based on comprehensive rescue databases may contribute to improved planning, training, and organization of medical search and rescue systems in mountain environments.