Mortality determiners for fall from height cases

Abstract

BACKGROUND:The aim of the present study was to investigate the role of body mass index (BMI) and trauma severity score systems on the mortality rates of patients undergoing surgery due to falls from height. METHODS:This retrospective study included 45 consecutive adult patients with multitrauma who were admitted and operated on due to a fall from height between January 2008 and December 2016. Patients were divided into mortality and recovery groups (n=10 and n=35, respectively). The groups were compared in terms of age, gender, weight, cause of the fall, height of the fall, location of the fall, BMI, trauma scores (Injury Severity Score [ISS], New Injury Severity Score [NISS], Glasgow Coma Scale [GCS], Abbreviated Injury Score [AIS], Revised Trauma Score [RTS]), hospital stay, and postoperative complications. RESULTS:There was no statistically significant difference between the two groups in terms of age, gender, and height or cause of the fall (p>0.05), whereas there was a statistically significant difference with respect to weight and BMI values (p<0.01). A statistically significant difference was determined between the groups in terms of hospital stay and postoperative complications (p<0.01) and ISS, NISS, GCS, AIS, and RTS scores (p<0.05). CONCLUSION:The effect of weight and BMI on the mortality rate of patients presenting with trauma as a result of a fall from height was objectively demonstrated in the present study. and heterogeneous pathophysiological patterns and different demographic factors, such as age, gender, and etiology. Methodologically, TSSs evaluate the severity of injury, including the anatomical severity and the level of physiological disorder, and convert the results into numerical data. These systems can determine the hospital stay and mortality rates, transfer suitable patients to proper facilities at the right time, compare large series, and eventually provide analyses of trauma care outcomes. [5] The purpose of establishing TSSs is to define the objective and comparable criteria for the determination of the severity of an injury. Anatomical location, physiological parameters, and trauma mechanisms are the three essential criteria to define the severity of an injury and also predict outcome. Moreover, these expedite the evaluation of various combinations of scoring systems. [6]

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

“…Some reports have found that fall height is not a factor aggravating the outcome of a fall from height injury 5 , 10 , but in our survey, as in other reports, we found that fall height was a significant factor 3 , 4 , 11 , 12 . The impact force is defined by mass (kg) × acceleration (m/s 2 ).…”

“…Therefore, initially, the prognosis and ISS values seemed much worse for those with suicide attempts than for their counterparts. However, mitigating factors such as younger age, lower body weight, and a higher rate of impact on the lower limbs outweighed these aggravating factors and led to better ISS values and prognoses in patients who attempted suicide compared with those we expected 5 , 17 , 18 . Therefore, a suicide attempt was not deemed an aggravating or a prognostic factor with respect to the ISS.…”

“…Various factors are related to the aggravation of the condition of patients who fell from height; amongst these factors, injury type and severity should be carefully considered when treating these patients. Some studies have investigated factors that affect the mortality of patients who fell from height and concluded that fall height, impact surface properties, alcohol consumption, psychiatric medicine use, suicide attempt, and body position at the time of surface impact worsen mortality rates 2 – 5 . However, because of the small number of studies, these results have not been fully confirmed.…”

Yoğun Bakım Ünitesinde Takip Edilen Kafa ve Göğüs Travması Hastalarında Mortalite Oranı Tahmin Edilebilir mi?

“…In this study, it was found that there was a statistically significant difference between low RTS and increased mortality. (11), also reported RTS statistically significant difference between low RTS and increased mortality. Similarly, (12) analyzed 1276 death trauma patients between 1995 and 2000 and showed that RTS could be used to predict mortality in trauma patients.…”

“…It was determined that there was at least one comorbid disease in 32.8% of the patients, 41.0% were intubated, 46.3% had enteral feeding, 4.5% needed hemodialysis, and 14.2% were ex. Median (min-max) values of some clinical and laboratory features of the patients were 14 (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15) for GKS, 26 for SAPS II, 6 (1-72) days for a stay in the intensive care unit, 1 (0-72) days for mechanical ventilation, 1 (0.00-7.90) mg / dL for creatinine, 3.4 (1.10-5.00) g / dL for albumin, 152 (65-380)mmol / L for Glucose (Table 1). It was found that mortality in trauma patients did not differ according to gender and age.…”