Hörauf Jason-Alexander, Nau Christoph, Mühlenfeld Nils, Verboket René D, Marzi Ingo, Störmann Philipp
Department of Trauma, Hand and Reconstructive Surgery, Hospital of the Johann Wolfgang Goethe-University Frankfurt am Main, 60590 Frankfurt am Main, Germany.
J Clin Med. 2022 Jan 28;11(3):697. doi: 10.3390/jcm11030697.
Falling down a staircase is a common mechanism of injury in patients with severe trauma, but the effect of varying fall height according to the number of steps on injury patterns in these patients has been little studied. In this retrospective study, prospectively collected data from a Level 1 Trauma Center in Germany were analyzed regarding the injury patterns of patients admitted through the trauma room with suspicion of multiple injuries following a fall down a flight of stairs between January 2016 and December 2019. In total 118 patients were examined which where consecutively included in this study. More than 80% of patients suffered a traumatic brain injury, which increased as a function of the number of stairs fallen. Therefore, the likelihood of intracranial hemorrhage increased with higher numbers of fallen stairs. Fall-associated bony injuries were predominantly to the face, skull and the spine. In addition, there was a high coincidence of staircase falls and alcohol intake. Due to a frequent coincidence of staircase falls and alcohol, the (pre-)clinical neurological assessment is complicated. As the height of the fall increases, severe traumatic brain injury should be anticipated and diagnostics to exclude intracranial hemorrhage and spinal injuries should be performed promptly to ensure the best possible patient outcome.
从楼梯上摔下是严重创伤患者常见的受伤机制，但根据楼梯级数不同的跌落高度对这些患者损伤模式的影响鲜有研究。在这项回顾性研究中，对德国一家一级创伤中心前瞻性收集的数据进行了分析，这些数据涉及2016年1月至2019年12月期间因怀疑从一段楼梯上摔下而多处受伤通过创伤室收治的患者的损伤模式。总共检查了118例患者，这些患者被连续纳入本研究。超过80%的患者患有创伤性脑损伤，其发生率随摔下楼梯的级数增加而上升。因此，颅内出血的可能性随着摔下楼梯级数的增加而增加。与跌倒相关的骨损伤主要集中在面部、颅骨和脊柱。此外，从楼梯上摔下与饮酒之间存在高度相关性。由于从楼梯上摔下与饮酒经常同时发生，（临床前）神经学评估变得复杂。随着跌落高度的增加，应预计会出现严重创伤性脑损伤，应及时进行诊断以排除颅内出血和脊柱损伤，以确保患者获得最佳预后。
