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Falls from scaffolds: a nationwide analysis

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European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Introduction

Falls from scaffolds are a common cause of occupational injuries and fatalities, however, the data concerning these injuries are scarce. The purpose of this study was to characterize the epidemiology, injury patterns, and outcomes of falls from scaffolds.

Methods

Retrospective cohort study using data from the National Trauma Data Bank (2007–2017). All adult patients who sustained injuries following falls from scaffolds and as a comparator, falls from ladders, were identified using the external cause of injury codes. The primary outcome was differences in the type and severity of injuries between the groups.

Results

A total of 183,853 patients were analyzed. Of these, 18,189 (9.9%) fell from scaffolds and 165,664 (90.1%) from ladders. Patients who fell from scaffolds were younger, more often male, and more likely to sustain severe trauma (ISS > 15: 24.1% vs 17.3%, p < 0.001). Falls from scaffolds resulted in more severe head injuries (head AIS ≥ 3: 18.6% vs 14.7%, p < 0.001) and more spinal fractures (30.3% vs 25.2%, p < 0.001). Falls from scaffolds were associated with higher mortality (2.5% vs 1.8%, p < 0.001), higher ICU admission rate (25.0% vs 21.5%, p < 0.001), and longer hospitalization. On multivariable analysis, the strongest predictors of mortality were GCS < 9 and hypotension on admission, severe (AIS ≥ 3) head injury, and age > 65 years.

Conclusion

Falls from scaffolds are associated with more severe injuries and worse outcomes compared to ladder falls. Males in the fourth decade of life were disproportionally affected. Further research on fall prevention is warranted to decrease this important cause of death and disability.

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Division of Trauma and Surgical Critical Care, Department of Surgery, Los Angeles County and University of Southern California Medical Center, Keck School of Medicine of the University of Southern California, 2051 Marengo Street, IPT, CSL 100, Los Angeles, CA, 90033, USA

    Panagiotis Kyriakou Liasidis, Cameron Ghafil, Morgan Schellenberg, Kazuhide Matsushima, Valerie Ponning Huang, Lydia Lam, Demetrios Demetriades & Kenji Inaba

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  1. Panagiotis Kyriakou Liasidis
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  7. Demetrios Demetriades
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Contributions

PKL and KI designed the study. PKL, CG, and VPH performed the literature search, data collection and data analysis. All authors contributed to the interpretation of the data, writing of the manuscript, and approved the final version of the manuscript. KI supervised all aspects of study design, data acquisition, analyses, and manuscript writing.

Corresponding author

Correspondence to Kenji Inaba.

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Conflict of interest

All authors declare no potential conflict of interest.

Ethics approval

This study was performed in line with the principles of the 1964 Helsinki Declaration and its later amendments. The Trauma Quality Improvement Program database contains de-identified data and a waiver of informed consent was obtained. The present study was approved by the Institutional Review Board of the University of Southern California.

Statement of human rights

The study was approved by the Institutional Review Board of the University of Southern California.

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Liasidis, P.K., Ghafil, C., Schellenberg, M. et al. Falls from scaffolds: a nationwide analysis. Eur J Trauma Emerg Surg 49, 813–823 (2023). https://doi.org/10.1007/s00068-022-02130-7

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