Casati Alberto, Granieri Stefano, Cimbanassi Stefania, Reitano Elisa, Chiara Osvaldo
General Surgery Unit, Policlinico Sant'Orsola-Malpighi, University of Bologna, Via Giuseppe Massarenti 9, 40138 Bologna, Italy.
General Surgery and Trauma Team, ASST Niguarda, Milano, Piazza Ospedale Maggiore 3, 20162 Milan, Italy.
J Clin Med. 2020 Sep 30;9(10):3175. doi: 10.3390/jcm9103175.
Falls from height (FFH) represent a distinct form of blunt trauma in urban areas. This study aimed to identify independent predictors of in-hospital mortality after accidental or intentional falls in different age groups. We conducted a retrospective study of all patients consecutively admitted after a fall in eight years, recording mechanism, intentionality, height of fall, age, site, classification of injuries, and outcome. We built multivariate regression models to identify independent predictors of mortality. A total of 948 patients with 82 deaths were observed. Among the accidental falls, mortality was 5.2%, whereas intentional jumpers showed a mortality of 20.4%. The death rate was higher for increasing heights, age >65, suicidal attempts, and injuries with AIS ≥3 (Abbreviated Injury Scale). Older patients reported a higher in-hospital mortality rate. Multivariate analysis identified height of fall, dynamic and severe head and chest injuries as independent predictors of mortality in the young adults' group (18-65 years). For patients aged more than 65 years, the only risk factor independently related to death was severe head injuries. Our data demonstrate that in people older than 65, the height of fall may not represent a predictor of death.
高处坠落（FFH）是城市地区钝性创伤的一种独特形式。本研究旨在确定不同年龄组意外或故意坠落患者院内死亡的独立预测因素。我们对八年内所有因坠落连续入院的患者进行了一项回顾性研究，记录了坠落机制、意图、坠落高度、年龄、部位、损伤分类和结局。我们建立了多变量回归模型来确定死亡的独立预测因素。共观察到948例患者，其中82例死亡。在意外坠落中，死亡率为5.2%，而故意跳楼者的死亡率为20.4%。随着坠落高度增加、年龄>65岁、自杀企图以及损伤严重程度评分（AIS）≥3（简明损伤定级标准），死亡率更高。老年患者的院内死亡率更高。多变量分析确定，坠落高度、动态性和严重性头部及胸部损伤是年轻成年人组（18 - 65岁）死亡的独立预测因素。对于65岁以上的患者，唯一与死亡独立相关的危险因素是严重头部损伤。我们的数据表明，在65岁以上人群中，坠落高度可能不是死亡的预测因素。
