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被送往创伤中心的跌倒损伤幸存者中跌倒距离与创伤严重程度的关系。

The Relationship Between Falling Distance and Trauma Severity Among Fall Injury Survivors Who Were Transported to a Trauma Center.

作者信息

Muneshige Kyoko, Miyagi Masayuki, Inoue Gen, Nakazawa Toshiyuki, Imura Takayuki, Matsuura Terumasa, Kawamura Tadashi, Kataoka Yuichi, Asari Yasushi, Takaso Masashi

机构信息

Department of Orthopedic Surgery, Kitasato University School of Medicine, Sagamihara, JPN.

Department of Emergency and Critical Care Medicine, Kitasato University School of Medicine, Sagamihara, JPN.

出版信息

Cureus. 2022 May 18;14(5):e25099. doi: 10.7759/cureus.25099. eCollection 2022 May.

Abstract

Introduction Falls from >6 meters have been shown to cause multiple traumas and serious injuries. However, especially among fall survivors who were transported to trauma centers, the relationship between falling distance and trauma severity remains unclear. This study aimed to investigate the relationship between falling distance and trauma severity among fall injury survivors who were transported to a trauma center and clarify the characteristics of trauma among survivors of falls from high places from an orthopedic surgeon's perspective. Methods We retrospectively reviewed the medical records of 65 fall injury survivors who were transported to a trauma center for falling distance; whether the fall was a suicide attempt; abdominal, chest, and head trauma; the numbers of upper-limb, lower-limb, and spinal vertebral fractures; McCormack load-sharing classification score; unstable pelvic fracture; Frankel classification; injury severity score (ISS); and duration of intensive care unit (ICU) and hospital stay. We evaluated the correlations between falling distance and the other factors and compared all factors between those falling <6 meters and those falling >6 meters. Results Falling distance was weakly positively correlated with durations of ICU and hospital stay. The percentage of cases that were suicide attempts, the number of lower-limb fractures, the McCormack load-sharing classification score, and the durations of ICU and hospital stay were significantly higher among those falling from >6 meters than among those falling from <6 meters. Conversely, there were no significant differences in abdominal trauma, chest trauma, head trauma, number of upper-limb fractures, number of vertebral fractures, unstable pelvic fracture, or Frankel classification between the two groups. Conclusion The findings indicate that falling from a higher distance may increase lower-limb and vertebral fracture severity and may lead to longer ICU and hospital stays among fall injury survivors who are transported to trauma centers.

摘要

引言 已证实,从6米以上高处坠落会导致多处创伤和重伤。然而,尤其是在被送往创伤中心的坠落幸存者中,坠落距离与创伤严重程度之间的关系仍不明确。本研究旨在调查被送往创伤中心的坠落伤幸存者中坠落距离与创伤严重程度之间的关系,并从骨科医生的角度阐明高处坠落幸存者的创伤特征。方法 我们回顾性分析了65例被送往创伤中心的坠落伤幸存者的病历,记录其坠落距离;坠落是否为自杀未遂;腹部、胸部和头部创伤情况;上肢、下肢和脊椎骨折的数量;麦科马克负载分担分类评分;不稳定骨盆骨折情况;弗兰克尔分级;损伤严重程度评分(ISS);以及重症监护病房(ICU)住院时间和住院总时长。我们评估了坠落距离与其他因素之间的相关性,并比较了坠落距离小于6米和大于6米的患者之间的所有因素。结果 坠落距离与ICU住院时间和住院总时长呈弱正相关。坠落距离大于6米的患者中自杀未遂病例的百分比、下肢骨折数量、麦科马克负载分担分类评分以及ICU住院时间和住院总时长显著高于坠落距离小于6米的患者。相反,两组在腹部创伤、胸部创伤、头部创伤、上肢骨折数量、脊椎骨折数量、不稳定骨盆骨折或弗兰克尔分级方面无显著差异。结论 研究结果表明,对于被送往创伤中心的坠落伤幸存者,从更高处坠落可能会增加下肢和脊椎骨折的严重程度,并可能导致更长的ICU住院时间和住院总时长。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ca29/9205290/1c87fdbd46cb/cureus-0014-00000025099-i01.jpg

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