Abstract
Falling down a staircase is a common mechanism of injury in patients with severe trauma, but the effect of varying fall height according to the number of steps on injury patterns in these patients has been little studied. In this retrospective study, prospectively collected data from a Level 1 Trauma Center in Germany were analyzed regarding the injury patterns of patients admitted through the trauma room with suspicion of multiple injuries following a fall down a flight of stairs between January 2016 and December 2019. In total 118 patients were examined which where consecutively included in this study. More than 80% of patients suffered a traumatic brain injury, which increased as a function of the number of stairs fallen. Therefore, the likelihood of intracranial hemorrhage increased with higher numbers of fallen stairs. Fall-associated bony injuries were predominantly to the face, skull and the spine. In addition, there was a high coincidence of staircase falls and alcohol intake. Due to a frequent coincidence of staircase falls and alcohol, the (pre-)clinical neurological assessment is complicated. As the height of the fall increases, severe traumatic brain injury should be anticipated and diagnostics to exclude intracranial hemorrhage and spinal injuries should be performed promptly to ensure the best possible patient outcome.
Highlights
According to the World Health Organization (WHO), falls are the second most common cause of accidental death from injury worldwide [1]
Patients were divided into three different groups depending on the reported fall height: 20 patients were assigned to the low fall group (1–5 steps), 40 to the intermediate fall group (6–10 steps), and 58 to the high fall group (>10 steps), respectively
We demonstrated that stair and escalator falls are associated with
Summary
According to the World Health Organization (WHO), falls are the second most common cause of accidental death from injury worldwide [1]. Depending on the trauma mechanism, both fall groups are associated with particular injury patterns. Thereby, ground-level falls affect the limbs, followed by the head [2], whereas falls from greater heights are related to injuries of the axial skeleton, such as the spinal column, or pelvic injuries, as well as head injuries [3,4]. Compared to ground level falls and falls from greater heights, stair falls are much less studied. Data on injury patterns and injury severity as a function of the number of stairs fallen are limited
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