Tsipouras S, Hendrie J M, Silvapulle M J
Emergency Department, Austin and Repatriation Medical Centre, Melbourne, VIC.
Med J Aust. 2001 May 21;174(10):516-9. doi: 10.5694/j.1326-5377.2001.tb143403.x.
To examine the nature, severity and outcomes of injuries sustained from ladder falls.
Retrospective survey of medical records.
Patients who presented after a fall from a ladder to the emergency department of a tertiary hospital in Melbourne, Victoria, between January 1994 and December 1997.
Demographic characteristics; height and mechanism of fall; injury site and Injury Severity Score (ISS); rate of hospital admissions.
163 patients presented after ladder falls. They were aged 2.5 to 86 years (mean age, 48 years); 83% were male, and 78% were injured in non-occupational settings. Almost half the accidents (43%) were caused by ladder instability (ladder sliding from position or tilting sideways). Most patients had mild or moderate injuries (usually of the extremities), but 13% had an ISS > or = 16 (indicating severe trauma), usually with head, chest or spinal injuries; 42% were admitted to hospital. Multiple regression analyses showed that ISS increased signficantly with height of fall and age (P< 0.05 for both), although a substantial amount of variation was not attributable to these variables. Likelihood of hospital admission increased linearly with increasing ISS to an ISS of 8 and remained high thereafter.
Ladder falls resulted in significant morbidity, with men undertaking non-occupational activities comprising most of those injured. New strategies to encourage safe ladder use are needed.
研究从梯子上跌落所致损伤的性质、严重程度及后果。
对病历进行回顾性调查。
1994年1月至1997年12月期间，在维多利亚州墨尔本一家三级医院急诊科就诊的从梯子上跌落的患者。
人口统计学特征；跌落高度及机制；损伤部位及损伤严重程度评分（ISS）；住院率。
163例患者因从梯子上跌落前来就诊。他们的年龄在2.5岁至86岁之间（平均年龄48岁）；83%为男性，78%在非职业环境中受伤。近一半的事故（43%）是由梯子不稳定（梯子从原位滑动或向一侧倾斜）引起的。大多数患者受轻伤或中度伤（通常为四肢受伤），但13%的患者ISS≥16（表明严重创伤），通常伴有头部、胸部或脊柱损伤；42%的患者住院治疗。多元回归分析显示，ISS随跌落高度和年龄显著增加（两者P<0.05），尽管相当一部分变异不能归因于这些变量。住院可能性随ISS增加呈线性上升，直至ISS为8，此后保持在高位。
从梯子上跌落导致显著的发病情况，从事非职业活动的男性是受伤的主要群体。需要采取新的策略来鼓励安全使用梯子。
