Yoshitake Hidenobu, Miyagi Naohisa, Yoshitomi Munetake, Komaki Satoru, Nakamura Yukihiko, Yamamoto Masafumi, Kajiwara Soushou, Takasu Osamu, Morioka Motohiro
Department of Neurosurgery, Kurume University School of Medicine.
No Shinkei Geka. 2018 Dec;46(12):1065-1071. doi: 10.11477/mf.1436203869.
We examined the clinical characteristics and outcomes of patients who had fallen from ladders and statistically analyzed the prognostic factors, highlighting the impact of the coexistence of head injuries on their prognoses. The clinical records of patients who had experienced ladder-related falls who were admitted to the Advanced Emergency Medical Service Center at Kurume University Hospital between April 2013 and August 2015 were retrospectively reviewed. A total of 86 patients were enrolled. The mean patient age was 69.2 years, and 82 patients were male. The median fall height was 2.55 m. Sixty patients fell during non-professional use of the ladder. Forty-four patients experienced some type of head injury. Although the older patients had more frequent complications with head injuries, the height of the fall was not related statistically. The group of patients with head injuries exhibited trends of older age, lower Glasgow Coma Scale scores, higher Injury Severity Score, and poorer outcomes than those of the group of patients without head injuries. Multivariate analysis showed that head injury and non-professional use were independent risk factors for poor outcomes. Our results revealed that ladder-related falls with head injury can occur when older people are working at home, even if they have fallen from a low height. Especially when older men work with the ladder at home, local community-based education and guidance for the prevention of ladder-related fall injuries are needed.
我们研究了从梯子上跌落患者的临床特征及预后情况,并对预后因素进行了统计学分析,着重强调了头部损伤共存对其预后的影响。回顾性分析了2013年4月至2015年8月期间入住久留米大学医院高级急救医疗服务中心的因梯子相关跌落受伤患者的临床记录。共纳入86例患者。患者平均年龄为69.2岁,男性82例。跌落高度中位数为2.55米。60例患者在非专业使用梯子时跌落。44例患者有某种类型的头部损伤。虽然老年患者头部损伤并发症更常见,但跌落高度与统计学无关。与无头部损伤的患者组相比,有头部损伤的患者组呈现出年龄更大、格拉斯哥昏迷量表评分更低、损伤严重度评分更高以及预后更差的趋势。多因素分析显示,头部损伤和非专业使用是预后不良的独立危险因素。我们的结果表明,即使老年人从较低高度跌落,在家中工作时也可能发生与梯子相关的跌落并伴有头部损伤。尤其是老年男性在家中使用梯子时,需要基于当地社区进行预防与梯子相关的跌倒损伤的教育和指导。