Analysis of the differences in polytraumatism due to falls from height according to the motivation of the mechanism: Accidental vs self-inflicted motivation

Abstract text (incl. references and figure legends)

INTRODUCTION

Falls from a height (FFH) are the second mechanism of death due to trauma in our environment. Our aim was to analyse if self-inflicted motivation had different trauma pattern or prognosis compared to accidental cases.

MATERIAL & METHODS

Retrospective descriptive study from our Prospective Registry of Severe Trauma (1993-2022) including all patients admitted after a FFH. The sample was stratified according to motivation: group A (accidental) and group B (suicide attempt). Demographics, trauma pattern and injury severity were analysed.

RESULTS

There were 437 patients included (A:76%; B:24%). Males predominated in both groups (A:78% vs B:51%). The median age was 35 and 28 years, respectively. Group B presented greater severity in terms of shock, OTI, need of emergency surgery and higher median hospital and ICU stay. No significant differences were found in mortality (Figure 1).

There was an increase in the number of cases over time at the expense of suicide attempts in the last 10 years (Figure 2). We observed a higher percentage of patients in group B with high heights, with statistical significance in the 10 to 14 meters´ group (A:18% vs. B:27%; p<0.04).

We found a higher percentage of patients in group B with injuries to the spine (62%), abdomen (59%), extremities (89%), and pelvis (70%).

CONCLUSIONS

In our experience FFH rates increased over the last 10 years mainly due to suicide attempts, causing more severe injuries and longer ICU stay. No difference was found in mortality rates probably because of the different injury pattern and younger age.

REFERENCES

Turgut, K., Sarihan, M. E., Colak, C., Güven, T., Gür, A., & Gürbüz, S. (2018). Falls from height: A retrospective analysis. World journal of emergency medicine, 9(1), 46–50.

Casati, A., Granieri, S., Cimbanassi, S., Reitano, E., & Chiara, O. (2020). Falls from Height. Analysis of Predictors of Death in a Single-Center Retrospective Study. Journal of clinical medicine, 9(10), 3175

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