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Low falls causing major injury: a retrospective study

Abstract

Background

Falling from a height of under 2 m (low fall) is the most common mechanism of injury causing major trauma in Ireland. This presentation encompasses a wide patient cohort, from paediatric sport injuries to elderly falls.

Aims

Our aim is to characterise major trauma resulting from a low fall, and its various sub-populations, to identify preventative strategies and care pathways to improve outcomes for patients.

Methods

The Trauma Audit and Research Network (TARN) which is used to provide Major Trauma Audit was used to retrospectively identify patients presenting to the Cork University Hospital Emergency Department with trauma resulting from a low fall from January 2015 to June 2018.

Results

The database returned 1066 qualifying cases (49.3% of cases in the time period), with a mean age of 67.3 years (SD = 21) and a median age of 71.3 years (IQR = 23); 44% were male. ‘Mechanical falls’ accounted for n = 513 (48%) of low-fall injuries, followed by ‘stationary falls’ n = 265 (25%). Injuries occurred most often at home n = 515 (48%), followed by public places n = 208 (19.5%). The most severely injured body region was the limbs n = 526 (49.3%), followed by the head n = 253 (23.7%). A number of patients with Glasgow Outcome Scores of 4 (moderate disability) and 5 (good recovery) were n = 488 (45.8%) and n = 390 (36.6%).

Conclusions

Low falls occur in patients over 55 years of age; many do not return to independent living. Wait times to initial assessment, length of hospital stay and mortality increase with age. Mechanical falls at home are the most common cause of low-fall major trauma.

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Acknowledgements

The authors acknowledge the invaluable help of Ann Deasy and Karina Caine, the TARN coordinators for CUH.

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Correspondence to Kathryn Lesko.

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Lesko, K., Deasy, C. Low falls causing major injury: a retrospective study. Ir J Med Sci 189, 1435–1443 (2020). https://doi.org/10.1007/s11845-020-02212-8

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  • DOI: https://doi.org/10.1007/s11845-020-02212-8

Keywords

  • Cohort
  • Low fall
  • Major trauma
  • Mechanical fall