Comparison of traumatic brain injury resulting from stair-related falls to falls from standing height-a neurotrauma center cohort.

BACKGROUND

Falls are the leading cause of traumatic brain injury (TBI) in high-income countries, and globally, the incidence of fall-related injuries is projected to rise. In this study, we compare TBI resulting from stair-related falls (SRFs) to falls from standing height (FSH), analyzing their epidemiology and outcomes.

METHODS

In a single-center, registry-based cohort study using the Oslo TBI Registry-Neurosurgery (OTBIR-N), we identified adults (≥18 years) admitted to Oslo University Hospital with TBI from either SRFs or FSH between 2015 and 2022. Epidemiology and outcome measures were compared between the two groups, and a multivariate logistic regression model was used to evaluate the adjusted effect of the fall mechanisms on dichotomized functional outcome (Glasgow outcome score (GOS) 1-3 vs. GOS 4-5).

RESULTS

A total of 1,432 patients with a median age of 71 years were included. SRFs represented 25%, while FSH represented 52% of all fall-related TBIs. SRF patients were generally younger and healthier, with a higher frequency of moderate to severe TBI than FSH patients (53% vs. 31%;  < 0.001). SRFs also occurred more often during evenings and nights, on weekends, and were more often related to alcohol influence (58% vs. 22%; p < 0.001). Both fall types resulted in unfavorable functional outcomes (GOS 1-3) for a substantial proportion of patients (37% in SRFs and 42% in FSH;  = 0.066). When adjusting for covariates in the multivariable logistic regression model, there was a tendency of SRFs being associated with unfavorable outcomes compared to FSH, but the effect was not statistically significant (OR 1.43, 95%CI 0.97-2.12;  = 0.073).

CONCLUSION

SRFs represented a considerable proportion of fall-related TBIs and were associated with poor outcomes in a substantial proportion of patients. Targeted public awareness campaigns addressing the risks associated with staircases, especially when combined with alcohol influence, seem warranted to prevent such injuries.