Falls from Great Heights: Risk to Sustain Severe Thoracic and Pelvic Injuries Increases with Height of the Fall.

Christoph Nau,Ingo Marzi,René D Verboket,Jason A Hörauf,Philipp Störmann,Maximilian Leiblein,Ramona Sturm

doi:10.3390/jcm10112307

Abstract

Falls from a height are a common cause of polytrauma care in Level I Trauma Centers worldwide. The expected injury consequences depend on the height of the fall and the associated acceleration, as well as the condition of the ground. In addition, we further hypothesize a correlation between the cause of the fall, the age of the patient, and the patient’s outcome. A total of 178 trauma patients without age restriction who were treated in our hospital after a fall >3 m within a 5-year period were retrospectively analyzed. The primary objective was a clinically and radiologically quantifiable increase in the severity of injuries after falls from different relevant heights (>3 m, >6 m, and >9 m). The cause of the fall, either accidental or suicidal; age and duration of intensive care unit stay, including duration of ventilation; and total hospital stay were analyzed. Additionally, the frequency of urgent operations, such as, external fixation of fractures or hemi-craniectomies, laboratory parameters; and clinical outcomes were also among the secondary objectives. Sustaining a thoracic trauma or pelvis fractures increases significantly with height, and vital parameters are significantly compromised. We also found significant differences in urgent pre- and in-hospital emergency interventions, as well as organ complications and outcome parameters depending on the fall’s height.

Highlights

Falling from a great height is a common reason for major trauma and is associated with high mortality and high overall injury severity [11]
Society for Trauma Surgery (DGU) recommends trauma team activation for fall heights greater than 3 m [12], which is in line with the guidelines of the American College of Surgeons
Demetriades et al reported that 2.3% of all traumatological hospital admissions were due to falls from a great height [13]

Summary

Introduction

Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. Falls from great heights, either accidentally or intentionally, are common traumatic circumstances in major trauma centers and are often associated with challenging long-term treatment. According to the World Health Organization (WHO), falls are the secondleading cause of accidental injury deaths worldwide, while more than 80% of falls occur in low- and middle-income countries [1]. A fall is defined as a downward movement of the body associated with a high kinetic energy, which ends in a sudden vertical deceleration [2]. The height of the fall determines the impact speed and its consequences. Injury patterns depend firstly on whether the body is slowed down during the fall and secondly on the ground conditions [3,4]

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Conclusion