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J Trauma. 2010 Oct;69(4):821-5. doi: 10.1097/TA.0b013e3181efc6c6.

Ground level falls are associated with significant mortality in elderly patients.

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1
Division of Acute Care and Trauma surgery, Department of Surgery, University of Rochester Medical Center, Rochester, New York, USA.

Abstract

BACKGROUND:

Falls from height are considered to be high risk for multisystem injury. Ground-level falls (GLF) are often deemed a low-energy mechanism of injury (MOI) and not a recommended triage criterion for trauma team activation. We hypothesize that in elderly patients, a GLF may represent a high-risk group for injury and concurrent comorbidities that warrant trauma service evaluation and should be triaged appropriately.

METHODS:

This is a retrospective study based on the National Trauma Data Bank. All patients with MOI consistent with GLF were identified. Demographics, type and severity of injuries, and outcomes were analyzed.

RESULTS:

We identified 57,302 patients with GLF. The group had 34% men, with mean age of 68 years ± 17 years and injury severity score of 8 ± 5. Overall mortality was 3.2%. There were 32,320 elderly patients (older than 70 years). The mortality in the elderly was significantly higher than the nonelderly (4.4% vs. 1.6%, p < 0.0001). The elderly were more likely to sustain long-bone fracture (54.5% vs. 35.9%, p < 0.0001), pelvic fracture (7.6% vs. 2.4%, p < 0.0001), and intracranial injury (10.6% vs. 8.7%, p<0.0001). Multivariate analysis showed that Glasgow Coma Scale (GCS) score <15 (odds ratio, 4.98) and older than 70 years (odds ratio, 2.75) were significant predictors of mortality inpatients after GLF.

CONCLUSIONS:

Patients older than 70 years and with GCS score <15 represent a group with significant inhospital mortality.

PMID:
20938268
DOI:
10.1097/TA.0b013e3181efc6c6
[Indexed for MEDLINE]
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