Factors influencing the injury severity score and the probability of survival in patients who fell from height

Abstract

In Japan, falls from height result in the second highest trauma mortality rate after traffic motor vehicle collisions and the highest trauma-related mortality rate amongst young people. We aimed to identify factors that worsen injury severity and lower survival probability of patients who fell from height and to contribute to the improvement of their prehospital and in-hospital care. This retrospective analysis retrieved hospital records of 179 patients aged ≥ 15 years who were transported to our hospital after a fall from height during April 2014–March 2020. On multiple regression analysis, fall height ≥ 5 m more significantly resulted in higher the injury severity score. Logistic regression analysis revealed that fall height ≥ 5 m with the reference of 2–3 m significantly resulted in lower the survival probability with odds ratio (95% confidence interval) of 0.10 (0.02–0.55). Using ‘feet-first’ as the reference body position, the odds ratios (95% confidence interval) of survival for those who impacted the surface on the lateral or dorsal regions were 0.11 (0.02–0.64) and 0.17 (0.03–0.99), respectively. Collecting information on the abovementioned factors at pre-hospitalisation may facilitate prompt diagnosis and treatment. These results may help improve prehospital and in-hospital care, avoiding preventable trauma deaths.

Characteristics of fall-from-height patients: a retrospective comparison of jumpers and fallers using a multi-institutional registry

“…We confirmed that fall height, age, and suicidal intent were major determinants of death. This is consistent with the results of previous studies on the determinants of death in fall patients [33,34]. Fall height is a major factor that influences vertical deceleration injury patterns, with studies suggesting 6 or 7.5 m as the height of a fatal fall [35][36][37][38].…”

Factors predicting oral and maxillofacial fractures after falling and factors predicting the duration of treatment

“…Therefore, if patients who have fallen from a height and injured their upper face are transported to a hospital at night, maxillofacial surgeons should suspect the occurrence of maxillofacial fractures. Generally, the height of the fall determines the kinetic energy transmitted to the patient, while the landing position and impact location determine the pattern and severity of the injury 22,26,27 . In the present study, although significant differences were found for impact location (i.e., between indoors and outdoors), when the fracture and non‐fracture groups were compared, this factor was not selected as significant after logistic regression analysis.…”

“…Some studies have determined that factors that affect the mortality of patients who have fallen from a height include the fall height, impact surface properties, alcohol consumption, psychiatric medication use, suicide attempts, and body position at the time of surface impact. 22,23 Additionally, significant factors affecting the occurrence of maxillofacial injuries in patients who have fallen have been determined to be age (especially >60 years) and lack of formal education. 6 In the present case series, the mandibular fracture was the most common type of fracture, accounting for 79.7% (47/59) of all fractures.…”

“…Although various factors are related to the aggravation of the condition of patients who have fallen, the injury type and severity should be carefully considered in the treatment of these patients. Some studies have determined that factors that affect the mortality of patients who have fallen from a height include the fall height, impact surface properties, alcohol consumption, psychiatric medication use, suicide attempts, and body position at the time of surface impact 22,23 . Additionally, significant factors affecting the occurrence of maxillofacial injuries in patients who have fallen have been determined to be age (especially >60 years) and lack of formal education 6 .…”

Medical and Diagnostic Measures for Damage to the Abdominal Organs in the Wounded and Victims With Catatrauma Against the Background of Explosive and Technogenic Injuries

“…It should be noted that the distribution of therapeutic and diagnostic tactics in successive stages with the allocation of resuscitation and diagnostic, resuscitation and post-shock stages was first provided by P. M. Zamyatin et al (2006) [15]. The probability of survival of the wounded and injured largely depends on the measures taken at different stages of rescue and medical care [16,17]:…”