Suicidal fall from heights trauma: difficult management and poor results

Falls from Height. Analysis of Predictors of Death in a Single-Center Retrospective Study

“…Our results were consistent with the literature with a median height of 6 m for non-survivors compared to 3 m for survived patients ( p < 0.001). As already reported by other studies [ 3 , 4 , 17 ], and even in our analysis, a significantly different distribution of mortality between accidental fallers (38/733—5.2%) and intentional jumpers (44/215—20.4%) after vertical deceleration trauma ( p < 0.001) has been noticed, both in adult and elderly age groups. In contrast to the higher rate of suicidal falls among elder women reported in previous work by our group [ 18 ], the present study pointed out a predominance of fallers among young adult males and a slight predominance of elder men among jumpers ( p < 0.001).…”

“…On the other hand, in case of accidental fall for the same height cluster, the orientation of the body during airtime cannot be controlled, leading to worse injuries. Indeed, as already reported by others [ 3 , 4 , 6 , 14 ], the first body region hitting the ground depends on body orientation during the time of flight, height, and intentionality of the fall. Suicidal attempts generally show as “feet-first” pattern of landing [ 4 , 15 ], whereas head injuries occur in unintentional falls with no control of the body during the fall.…”

“…In Western countries, FFH represents one of the leading causes of admission to the Emergency Department [ 8 ], accounting for about 10% of all trauma patients [ 2 ]. This type of trauma represents the most common mechanism of self-inflicted injury [ 3 ], especially in the presence of specific underlying conditions such as psychiatric disease, drug, or alcohol abuse with a subsequent altered mental status. In urban areas, FFH represents the most frequent method of suicide attempt [ 9 ].…”

“…Falls from height (FFH) represent a distinct form of blunt trauma in which rapid vertical deceleration determines injuries to the victim’s body [ 1 ]. Falls account for almost 10% of all trauma admitted to the Emergency Department, mostly accidental (85%) [ 2 ] and in part intentional [ 3 ], the so-called “jumpers”. Outcomes and injury patterns depend on multiple environmental factors like height of fall, speed at impact, landing surface as well as victim’s characteristics such as age, position at impact, comorbidities, and intentionality of fall.…”

Suicide Attempts from Height and Injury Patterns: An Analysis of 64 Cases

“…From a mechanical point of view, during a fall from height, potential (dynamic) energy is converted into kinetic and this leads to fractures upon impact. Another important factor of the severity of injuries is the height of fall, as the kinetic energy is increasing due to acceleration during the fall and is maximum at the time of impact [60]. In suicide falls, kinetic energy is absorbed mainly by the lower limbs, pelvis and spine, leading to characteristic fracture patterns.…”