Lau G, Ooi P L, Phoon B
Department of Forensic Medicine, Institute of Science and Forensic Medicine, Singapore.
Forensic Sci Int. 1998 Apr 22;93(1):33-44. doi: 10.1016/s0379-0738(98)00027-9.
The authors undertook a review of fatal falls from a height, that occurred in 1991-92 in Singapore, with the objective of constructing mathematical models relating the height of fall to the injuries sustained. The 603 cases studied showed a mean age of 41.4 years with a male to female ratio of approximately 2:1. A sub-sample of 416 (69%) of these subjects had fallen from known heights (mean, 26.9 m; range, 3-69.6 m) and were studied in further detail. Bivariate analysis of this group showed that their injury severity score (ISS) was significantly correlated with the height of fall (H) and age (P < 0.01; r = 0.412 and 0.187, respectively). As the ISS is not strictly a continuous variable and varied markedly with H, it was categorised into bands (ISSB) before being subjected to further analysis. Regression modelling to adjust for mutual confounding showed that both height of fall and age were significant independent determinants of the ISSB (P < 0.0001). A model with H as the dependent variable was then constructed to relate the height of fall to ISSB and other statistically significant indicators of the extent and the severity of the injuries sustained. A second model with bands of height (HB) as the dependent variable was similarly constructed to assess the effect of banding both height and ISS. Our findings suggested that the height of fall was significantly associated with age, ISS and the extent of injury (mostly AIS > or = 3), and confirmed the usefulness of these models for investigative purposes. Statistical models could be designed and used to assess any apparent discrepancy between injury severity as determined at autopsy and the suspected/alleged height of fall.
作者对1991 - 1992年发生在新加坡的致命高空坠落事件进行了回顾，目的是构建将坠落高度与所受伤害相关联的数学模型。所研究的603例病例显示，平均年龄为41.4岁，男女比例约为2:1。其中416例（69%）的子样本从已知高度坠落（平均26.9米；范围3 - 69.6米），并对其进行了更详细的研究。对该组进行的双变量分析表明，他们的损伤严重度评分（ISS）与坠落高度（H）和年龄显著相关（P < 0.01；r分别为0.412和0.187）。由于ISS并非严格意义上的连续变量，且随H变化显著，因此在进行进一步分析之前，将其分类为不同等级（ISSB）。用于调整相互混杂因素的回归模型表明，坠落高度和年龄都是ISSB的显著独立决定因素（P < 0.0001）。然后构建了一个以H为因变量的模型，以将坠落高度与ISSB以及所受伤害程度和严重程度的其他统计学显著指标相关联。类似地构建了一个以高度等级（HB）为因变量的第二个模型，以评估对高度和ISS进行分级的效果。我们的研究结果表明，坠落高度与年龄、ISS以及损伤程度（大多为AIS≥3）显著相关，并证实了这些模型在调查目的方面的有用性。可以设计并使用统计模型来评估尸检确定的损伤严重程度与怀疑/声称的坠落高度之间的任何明显差异。
