Low-Impact Falls: Demands on a System of Trauma Management, Prediction of Outcome, and Influence of Comorbidities

Kennedy, Richard L.; Grant, P T; Blackwell, David

doi:10.1097/00005373-200110000-00016

Cited by 62 publications

(47 citation statements)

References 28 publications

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“…Falls are common in the elderly [30,31] and are associated with increased risk of hip and other osteoporotic fractures [8,32]. However, there is a general impression that falls are not important in the pathogenesis of vertebral fractures and that most of these fractures are precipitated by routine everyday activities, like lifting and bending [33].…”

Section: Discussionmentioning

confidence: 99%

Rate and circumstances of clinical vertebral fractures in older men

et al. 2007

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Summary-We examined the rate of clinical vertebral fractures, and the circumstances associated with the fractures, in a cohort of 5,995 US older men. Fractures were more common in the most elderly men, and were usually associated with falls and other low-energy trauma.Introduction-Little is known about clinical vertebral fractures in older men. We postulated that clinical vertebral fractures occur with falls, affect men with osteoporosis, and are more common as age increases.

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Section: Discussionmentioning

confidence: 99%

Rate and circumstances of clinical vertebral fractures in older men

et al. 2007

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“…1 The majority of cases are classified as blunt trauma, and this broad categorization includes different mechanisms such as motor vehicle collisions and low falls. The TRISS has been shown to be a poor predictor of survival following falls at a low level 18,19 and injuries resulting from motorcycle or pedestrian incidents. 20 The inability to distinguish between types of penetrating injuries, such as gunshot wounds and stabbing injuries, has also been identified as a limitation of the TRISS methodology.…”

Section: Components Of Trissmentioning

confidence: 99%

“…The TRISS has been shown to be a poor predictor of survival following falls at a low level 18,19 and when multiple severe injuries are sustained in one body region. 18 The inability to distinguish between types of penetrating injuries, such as gunshot wounds and stabbing injuries, has also been identified as a limitation of the TRISS methodology, 18 whereas high misclassification rates have been observed for severely injured patients (ISS > 20), older patients, and patients with severe head injuries.…”

Section: Practical Applications Of Trissmentioning

confidence: 99%

TRISS: Does It Get Better than This?

Gabbe

Cameron

Wolfe

2004

Academic Emergency Medicine

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The Trauma and Injury Severity Scoring (TRISS) system was developed in the 1980s to improve the prediction of patient outcomes following trauma through the use of physiological and anatomical criteria. The TRISS is used for a number of purposes, including quantifying the severity of injury of a patient population, calculating the probability of survival of patients for identification of cases for peer review, and comparing the death or survival rates of different populations/hospitals. Despite the advancements in trauma care, improved statistical techniques, and the identification of numerous limitations of TRISS, it continues to be the most commonly used tool for judging hospital performance and monitoring trauma death rates. This article critically evaluates the development, structure, and practical use of TRISS to determine its value in the current trauma environment. Limitations of TRISS are discussed and suggestions are made for the future development of trauma prediction tools.

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“…Fall from height remain a significant cause of morbidity and mortality in day to day life. Factors determining serious and fatal injuries in a fall depends on distance of the fall, the characteristics of landing surface, orientation on falling, and whether the fall was direct or broken 1 . Factors contributing to falls from heights include faulty equipment, such as ladders and scaffold structures, and human factors, …”

Section: Introductionmentioning

confidence: 99%

Pattern of fatal injury in fall from height cases- a medicolegal study

Ahmad

Rahman

Al-Azad

et al. 2015

J. Armed Forces Med. Coll.

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Introduction: In occupational settings, the most common type of fatal accident is fall from a height. The skull, brain, spinal cord and extremities are the most commonly injured systems. Falls from more than 20 feet have historically been triaged to trauma centers but even low-level falls can cause serious head injuries and death. Objectives: The objective of this study was to find out the pattern of injuries and related medico-legal issues among the victims of fall from height. Methods: This retrospective study was conducted among the victims of fall from height at Dhaka Medical College morgue during the period of January to December 2008.Various data were collected from inquest reports submitted by the investigating officers. Specific points regarding injuries were noted during autopsy examinations. Results: A total 2714 autopsies were performed during the study period out of which 93(3.43%) were cases of fall from height. Among them 66(70.97%) were male and 27(29.03%) victims were female. Most of the victims 23(24.73%) were day labourer/ construction workers. Minimum level of height of fall was from 2nd floor 7(7.52%) and maximum number of victim have fallen from 5th to 10th floor 47(50.53%). Considering timing, highest incidents occurred during day time 57(61.29%). Ages of maximum victims were between 21-30 years 34(36.56%). All the victims had multiple abrasions and bruises in their body, followed by laceration 74(79.56%), fracture of skull 57(61.29%) 80 JAFMC Bangladesh. Vol 10, No 1 (June) 2014 intra cranial haemorrrhage 85(91.40%), injury to long bones of lower limbs 47(50.54%), injury to long bones of upper limbs 31(33.33%), injury to abdominal organs like liver, spleen, kidney 51(54.84%), fracture of pelvis 37(39.78%). In skull, linear fracture was the commonest one 48(51.61%), Temporal bone was the commonest bone to fracture 57(61.29%) and most of the victims 57(61.29%) had sub dural haemorrhage. Conclusion: Death due to fall from height is an unforeseen and unfortunate occurrence. Installation of window guard, modification of physical environment, maintenance of safety as per building construction code, parental counseling to children can reduce this economical burden and protect vulnerable groups of people of our country from this type of incidents. DOI: http://dx.doi.org/10.3329/jafmc.v10i1.22930 Journal of Armed Forces Medical College Bangladesh Vol.10(1) 2014

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Low-Impact Falls: Demands on a System of Trauma Management, Prediction of Outcome, and Influence of Comorbidities

Cited by 62 publications

References 28 publications

Rate and circumstances of clinical vertebral fractures in older men

Rate and circumstances of clinical vertebral fractures in older men

TRISS: Does It Get Better than This?

Pattern of fatal injury in fall from height cases- a medicolegal study

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