Prognostic factors for mortality following falls from height

Aim

To identify the potential prognostic factors for mortality after falls from height.

Method

A retrospective clinical observational study included victims of fall of >6 m from October 2000 to December 2007. Variables studied comprised each casualty's age, gender, height of fall, Glasgow Coma Scale (GCS) score, Abbreviated Injury Scale scores, Injury Severity Score, heart rate, Mean Arterial Pressure (MAP), White Blood Cell (WBC) count, haemoglobin, serum glucose, Creatine Kinase and duration of hospital stay. The relationships between these variables and outcomes were evaluated.

Results

Among the 66 patients studied the mortality rate was 22.7%, i.e. 7 out-of-hospital and 8 in-hospital deaths. In univariate analysis, Glasgow Coma Score ≤14, Injury Severity Score ≥16, head/neck Abbreviated Injury Scale score ≥4, chest Abbreviated Injury Scale score ≥4, heart rate ≥100 or ≤50 beats/min, Mean Arterial Pressure ≤60 and serum glucose ≥140 mg/dl were significantly related to mortality. In multivariate analysis, head/neck Abbreviated Injury Scale score ≥4 was independently correlated with mortality.

Conclusions

Severe head injury (head/neck Abbreviated Injury Scale score ≥4) is a significant factor for mortality following falls from >6 m.