Falls from a balcony while intoxicated: a new injury trend among young adults?

Abstract

Background Unintentional falls from heights, including balconies, result in life threatening traumatic injury. Alcohol, when combined with environmental factors and poor judgement, can potentially lead to fatal outcomes. One trauma center’s registry identified a group of young adults falling from balconies and we investigated the role of alcohol. Methods Hospital trauma service admissions from 2010 through 2017 were reviewed for unintentional falls from heights. Suicide attempts and unintentional falls off ladders or roofs were excluded. Data were obtained from trauma registry and medical record review, as well as social work service interviews. Results Falls from heights comprised 4.8% of injuries treated at our trauma center during the eight-year study period with 98.5% admitted. Of patients admitted because of falls, 10.3% (55/532) were from a balcony. The majority of this group of patients was male and 19–29 years old (67%). Of patients with a blood alcohol concentration (BAC) determination, 62% had a positive BAC upon hospital admission with an average of 0.20 g/dL among those 34 patients. No gender differences were evident for alcohol use. Seven of the eight patients under the legal drinking age of 21 years were a subgroup with high alcohol use as compared with patients 21 years and older ( p = 0.099). Ninety-four percent of falls occurred at residential locations such as dormitories or apartment complexes, often during a social event. Backward falls off railings and attempts to jump to adjoining balconies were common. Head, thorax/abdomen, and extremity fractures were common, with an average injury severity score (ISS) of 16. Average length of hospital stay was 8 days. Most patients (67%) were discharged home after hospital stay, but 21% were transferred to inpatient rehabilitation or skilled nursing facilities. There were two deaths. Conclusions Falls from balconies among young adults occur in our area yet the true frequency of these events remain unknown. Occurrence was most common among underage drinkers. Generalization is difficult with this small sample, yet high risk behaviors and environmental factors were evident. It is imperative that educational programs focus on this population with collaborative prevention efforts focused on the dangers of, and increased risk of injury associated with the balcony environment.

Changes in Injury Patterns Associated With Elevated Blood Alcohol Level

“…3 The higher the level of intoxication also leads to the higher chances of falls. 4 Intoxicated patients who binge drink alcoholic beverages are associated with an increased risk of traumatic fall injuries than patients who do not binge. 4 A common fall seen with middle-aged intoxicated patients is unintentional falls off of balconies, leading to injuries and, in certain cases, death.…”

“…4 Intoxicated patients who binge drink alcoholic beverages are associated with an increased risk of traumatic fall injuries than patients who do not binge. 4 A common fall seen with middle-aged intoxicated patients is unintentional falls off of balconies, leading to injuries and, in certain cases, death. 4 Patients who have sustained injuries due to traumatic falls, whether while sober or intoxicated, have a significantly higher chance of a repeated fall.…”

“…4 A common fall seen with middle-aged intoxicated patients is unintentional falls off of balconies, leading to injuries and, in certain cases, death. 4 Patients who have sustained injuries due to traumatic falls, whether while sober or intoxicated, have a significantly higher chance of a repeated fall. 3 Further investigation of sober vs intoxicated fall injury patterns is critical for improved public health outreach, education, and prevention.…”

Falling off a balcony: a student experiment

“…A person falling off a balcony is likely to be seriously injured or killed. It is not an uncommon problem, even in college campuses, and the average hospital admission cost is $280 000 per patient [1]. For that reason, balcony walls and handrails on stairs are subject to building regulations that require a minimum height of about 1 m. That height is above the centre of mass of most people, so it is assumed that accidental falls are less likely to occur.…”