Archives of Emergency Medicine, 1991, 8, 245-252
Injuries sustained by falls
G.S. ROZYCKI & K.
Department of Surgery, University of Tennessee Medical Center, Knoxville, Tennessee,
During a recent 4-year period, 381 patients were admitted with injuries sustained
from falls. Equal numbers of patients were less than and greater than 50 years of
age and included 53 children (- 16 years) and 214 elderly (>55 years). Falls from
heights occurred predominately in young males (mean age 34.2 years), were most
commonly job or recreation related and resulted in higher injury severity scores
(ISS). Falls in the elderly occurred more commonly in women, typically on a flat
surface, and were less severe. Despite lower mean ISS, fall victims over 55 years of
age had longer hospitalizations (11-4 vs. 4-5 days) and incurred higher hospital
charges compared to younger patients. There were 35 deaths (9-2%). In patients
under 55 years, deaths resulted from fall-related central nervous system (CNS)
injury and/or multisystem trauma. In patients over 55 years, fatalities were most
commonly related to pre-existent medical conditions.
Based on a review of this experience, we conclude that:
(1) unlike other causes of blunt and penetrating trauma, both sexes are equally
at risk from fall-related injuries but sex incidence is age related;
(2) falls from heights are more common in men;
(3) advanced age and pre-existing medical conditions account for the increased
morbidity and mortality following falls and;
(4) cost containment measures for fall-related trauma must consider not only
injury severity, but the age and pre-existent medical conditions of the patient.
Falls are the second leading cause of both spinal cord and brain injury (accounting
for 20% of CNS trauma in the United States) and constitute a major cause of trauma
deaths in all ages (Maull et al., 1981; Barancik et al., 1983). In addition, falls are the
most common cause of non fatal injury. Each year one person in 20 is injured
Correspondence: Kimball I. Maull, M.D., Department of Surgery, University of Tennessee Medical Center,
1924 Alcoa Highway, Knoxville, Tennessee 37920, U.S.A.
G. S. Rozycki & K. I. Maull
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