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Published on: August 17, 2017
Low falls causing major injury: a retrospective study
Kathryn Lesko1, Conor Deasy2,3
1School of Medicine, University College Cork, Cork, Ireland. 116100302@umail.ucc.ie.
Insights
Low falls are a common cause of major trauma, particularly in older adults. Mechanical falls at home are the most frequent cause, often leading to long-term disability and increased mortality with age.
Area of Science:
- Traumatology
- Geriatric Medicine
- Public Health
Background:
- Falls from under 2 meters (low falls) represent the leading cause of major trauma in Ireland.
- This injury mechanism affects a broad demographic, from children to the elderly.
Purpose of the Study:
- To characterize major trauma from low falls and identify patient subgroups.
- To inform preventative strategies and optimize care pathways for improved patient outcomes.
Main Methods:
- Retrospective analysis of patients presenting with low-fall trauma to Cork University Hospital Emergency Department.
- Data collected from the Trauma Audit and Research Network (TARN) between January 2015 and June 2018.
Main Results:
- 1066 cases of low-fall major trauma were identified (49.3% of major trauma cases).
- The average patient age was 67.3 years, with mechanical falls at home being the most common cause (48%).
- Limb injuries were most frequent (49.3%), with 45.8% experiencing moderate disability and 36.6% achieving good recovery.
Conclusions:
- Low falls disproportionately affect individuals over 55, frequently resulting in loss of independent living.
- Advanced age correlates with increased wait times, longer hospital stays, and higher mortality rates.
- Mechanical falls occurring in the home environment are the primary driver of low-fall related major trauma.
Background:
Falling from a height of under 2 m (low fall) is the most common mechanism of injury causing major trauma in Ireland. This presentation encompasses a wide patient cohort, from paediatric sport injuries to elderly falls.
Aims:
Our aim is to characterise major trauma resulting from a low fall, and its various sub-populations, to identify preventative strategies and care pathways to improve outcomes for patients.
Methods:
The Trauma Audit and Research Network (TARN) which is used to provide Major Trauma Audit was used to retrospectively identify patients presenting to the Cork University Hospital Emergency Department with trauma resulting from a low fall from January 2015 to June 2018.
Results:
The database returned 1066 qualifying cases (49.3% of cases in the time period), with a mean age of 67.3 years (SD = 21) and a median age of 71.3 years (IQR = 23); 44% were male. 'Mechanical falls' accounted for n = 513 (48%) of low-fall injuries, followed by 'stationary falls' n = 265 (25%). Injuries occurred most often at home n = 515 (48%), followed by public places n = 208 (19.5%). The most severely injured body region was the limbs n = 526 (49.3%), followed by the head n = 253 (23.7%). A number of patients with Glasgow Outcome Scores of 4 (moderate disability) and 5 (good recovery) were n = 488 (45.8%) and n = 390 (36.6%).
Conclusions:
Low falls occur in patients over 55 years of age; many do not return to independent living. Wait times to initial assessment, length of hospital stay and mortality increase with age. Mechanical falls at home are the most common cause of low-fall major trauma.
