Fatal falls from height: Pattern of injuries and effect of level of fall

F. Kandeel, R. Azab
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Abstract

In both clinical and forensic medicine, injuries resulting from falls establish a non-negligible ratio of patients and post-mortem examinations. Aim: The aim of this study is to assess the pattern of injuries and effect of level of fall among cases of fatal falls from height admitted to Menoufia University Hospital from the first of June 2016 to the end of May 2021. Patients & methods: This retrospective study data was retrieved from patients' medical reports and from patients' hospital records using a special questionnaire prepared for this purpose. Data were collected including socio-demographic data, fall characteristics (time and place of occurrence), the height of fall (fall height was classified into two categories: high (≥ 6 meter and low < 6meter), circumstances, injury pattern (site and type of injuries), duration of survival, level of consciousness according to Glasgow coma scale and possible cause of death. Results: The most represented age group was 18-<40years (41.5%) . Most of the cases were males (73.6%), accidental (98.1%), fell from ≥6 meters (56.6%), occurred at home (62.3%), at daytime (77.4), and 58.5% of cases showed injuries at multiple anatomical regions in the body. The level of fall significantly affected survival duration and types of chest and abdominal injuries. Central nervous system impairment was the cause of death in 73.6% of cases. Most patients (71.7%) had a Glasgow coma scale below 8. Conclusion : most cases were accidental, males, occurred at home, with multiple injuries. The level of fall significantly affected survival duration and types of chest and abdominal injuries. Recommendations: Necessary precautions to prevent accidental falls and safety measures for construction workers and window cleaners are mandatory.
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致命的高空坠落:伤害模式和坠落程度的影响
在临床和法医学中,跌倒造成的伤害在病人和尸检中都占有不可忽视的比例。目的:本研究的目的是评估2016年6月1日至2021年5月底Menoufia大学医院收治的致命高空坠落病例的损伤模式和坠落水平的影响。患者和方法:本回顾性研究的数据来自患者的医疗报告和患者的医院记录,使用为此目的准备的特殊问卷。收集的数据包括社会人口学数据、跌倒特征(发生时间和地点)、跌倒高度(跌倒高度分为高(≥6米和低< 6米)两类)、情况、损伤类型(损伤部位和类型)、生存时间、根据格拉斯哥昏迷量表的意识水平和可能的死亡原因。结果:18-<40岁为最典型年龄组(41.5%)。以男性(73.6%)、意外(98.1%)、从6米以上跌落(56.6%)、在家(62.3%)、白天(77.4)发生最多,58.5%的病例表现为身体多解剖区损伤。跌倒程度显著影响生存时间和胸腹损伤类型。73.6%的病例死亡原因为中枢神经系统损伤。大多数患者(71.7%)格拉斯哥昏迷评分低于8分。结论:大多数病例为意外事故,男性,发生在家中,多发伤。跌倒程度显著影响生存时间和胸腹损伤类型。建议:建筑工人和窗户清洁工必须采取必要的预防措施和安全措施,以防止意外坠落。
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