Falls from height: A retrospective analysis

doi:10.5847/wjem.j.1920-8642.2018.01.007

Abstract

Abstract:

BACKGROUND: Emergency services manage trauma patients frequently and falls from height comprise the main cause of emergency service admissions. In this study, we aimed to analyse the demographic characteristics of falls from height and their relationship to the mortality.
METHODS: A total of 460 patients, who admitted to the Emergency Department of Inonu University between November 2011 and November 2014 with a history of fall from height, were examined retrospectively. Demographic parameters, fall characteristics and their effect to mortality were evaluated statistically.
RESULTS: The study comprised of 292 (63.5%) men and 168 (36.5%) women patients. The mean age of all patients was 27±24.99 years. Twenty-six (5.6%) patients died and the majority of them were in ≥62 years old group. The highest percentage of falls was at 0-5 years age group (28.3%). People fell mainly from 1.1-4 metres(m) level (46.1%). The causes of falls were ordered as unintentional (92.2%), workplace (8.1%) and suicidal (1.7%). Skin and soft tissue injuries (37.4%) were the main traumatic lesions.
CONCLUSION: Age, fall height, fall place, linear skull fracture, subarachnoidal hemorrhage, cervical fracture, thoracic vertebra fracture and trauma scores had statistically significant effect on mortality. The casualties died because of subarachnoid hemorrhage mostly.

Key words: Trauma, Falls, Mortality, Emergency medicine

Kasim Turgut, Mehmet Ediz Sarihan, Cemil Colak, Taner Güven, Ali Gür, Sükrü Gürbüz. Falls from height: A retrospective analysis[J]. World Journal of Emergency Medicine, 2018, 9(1): 46-50.

Figures/Tables 4

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Variables	Survivor (n=434)	Died (n=26)	Total	P
Gender
Male	162 (96.4)	6 (3.6)	168 (100)	0.21
Female	272 (93.1)	20 (6.9)	192 (100)
Age(years)
0-5	129^a (99.2)	1^b (0.8)	130 (100)
6-15	83^a (97.6)	2^a (2.4 )	85 (100)
16-30	74^a (96.1)	3^a (3.9)	77 (100)
31-45	48^a (96)	2^a (4)	50 (100)	<0.001
46-61	49^a (94.2 )	3^a (5.8)	52 (100)
≥62	51^a (77.3)	15^b (22.7)	66 (100)
Fall height (meters)
≤1	183^a (97.9)	4^b (2.1)	187 (100)	<0.001
1.1-4	202^a (95.3)	10^a (4.7)	212 (100)
4.1-9	36^a (81.8)	8^b (18.2)	44 (100)
>9	13^a (76.5)	4^b (23.5)	17 (100)
Ground of fall
Hard	360 (93.5)	25 (4.5)	385 (100)	0.10
Soft	74 (98.8)	1 (1.2)	75 (100)
Cause of fall
Workplace accident	34 (91.9)	3 (8.1)	37 (100)
Suicide	7 (87.5)	1 (12.5)	8 (100)	0.44
Unintentional	393 (94.7)	22 (5.3)	415 (100)
Place of fall
Balcony	104^a (92.9)	8^a (7.1)	112 (100)
Stairs	99^a (94.3)	6^a (5.7)	105 (100)
Tree	38^a (97.4)	1^a (2.6)	39 (100)
Domestic furniture	68^a (100)	0^b (0)	68 (100)
Roof	27^a (84.4)	5^b (15.6)	32 (100)	0.008
Lap	8^a (88.9)	1^a (11.1)	9 (100)
Child park	42^a (100)	0^a (0)	42 (100)
Construction scaffold	9^a (75)	3^b (25)	12 (100)
Others	39 (95.1)	2^b (4.9)	41 (100)
Fall time (o’clock)
00:01-06:00	16 (100)	0 (0 )	16 (100)
06:01-12:00	92 (93.9)	6 (6.1)	98 (100)	0.83
12:01-18:00	196 (94.2)	12 (5.8)	208 (100)
18:01-24:00	130 (94.2)	8 (5.8)	138 (100)

Variables	Survivor	Died	Total	P
Skin and soft tissue injuries	172 (100)	0 (0)	172 (100)
Head
Lineer fracture	33^a (94.3)	2^b (5.7)	35 (100)
Facial bone fracture	16^a (94.1)	1^a (5.9)	17 (100)
Epidural hemorhage	9^a (90)	1^a (10)	10 (100)	0.002
Subdural hemorhage	18^a (72)	7^a (18)	25 (100)
Subarachnoidal hemorhage	17^a (56.7)	13^b (43.3)	30 (100)
Thorax
Rib fracture	26 (74.3)	9 (25.7)	35 (100)
Pneumothorax	13 (68.4)	6 (31.6)	19 (100)	0.79
Hemothorax	5 (62.5)	3 (37.5)	8 (100)
Abdomen-pelvis
Liver injury	5 (71.4)	2 (28.6)	7 (100)
Splenic injury	6 (100)	0 (0)	6 (100)	0.44
Pelvic fracture	7 ( 70 )	3 (30)	10 (100)
Vertebral system
Cervical fracture	8^a (66.7)	4^b (33.3)	12 (100)
Thoracic fracture	10^a (100)	0^b (0)	10 (100)	<0.001
Lumbosacral fracture	27^a(96.4)	1^a (3.6)	28 (100)
Extremities
Upper extremity fracture	61 (98.4)	1 (1.6)	62 (100)
Lower extremity fracture	43 (95.6)	2 (4.4)	45 (100)	0.57

Variables	≤1 meters	1.1-4 meters	4.1-9 meters	>9 meters	P
GCS	14.50±1.46	14.20±2.10	11.60±4.20	11.00±11.00	<0.000001
AIS	3.10±1.70	4.70±2.31	8.00±3.70	8.80±3.66	<0.000001
ISS	8.24±9.10	11.67±10.00	24.70±15.63	30.76±16.03	<0.000001
NISS	8.33±9.64	12.10±11.23	27.50±18.39	31.20±16.03	<0.000001
RTS	7.70±0.46	7.58±0.76	6.63±1.80	5.79±2.34	<0.000001
TRISS	97.10±10.10	94.47±16.65	78.10±33.45	71.61±36.22	<0.000001
CRAMS	9.40±1.15	9.16±1.59	7.50±2.77	6.41±2.50	<0.000001

Variables	Survivor (n=434)	Died (n=26)	P
GCS	14.40±1.55	6.00±2.73	0.0001
AIS	4.21±2.42	10.00±3.62	0.0001
ISS	10.64±10.00	38.70±13.04	0.0001
NISS	11.07±11.20	40.85±14.93	0.0001
RTS	7.68±0.46	4.00±1.56	0.0001
CRAMS	9.30±1.30	4.11±1.82	0.0001
TRISS	97.05±8.63	27.40±25.45	0.0001

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