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Journal Article

Citation

Spaniolas K, Cheng JD, Gestring ML, Sangosanya A, Stassen NA, Bankey PE. J. Trauma 2010; 69(4): 821-825.

Affiliation

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

Copyright

(Copyright © 2010, Lippincott Williams and Wilkins)

DOI

10.1097/TA.0b013e3181efc6c6

PMID

20938268

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.


Language: en

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