Falls from height are considered to be high risk for multisystem injury. Ground-level falls (GLF) are often deemed a low-energy mechanism of injury (MOI) and not a recommended triage criterion for trauma
team activation. We hypothesize that in elderly
patients, a GLF may represent a high-risk group for injury and concurrent comorbidities that warrant trauma
service evaluation and should be triaged appropriately.
This is a retrospective study based on the National Trauma
Data Bank. All patients with MOI consistent with GLF were identified. Demographics, type and severity of injuries, and outcomes were analyzed.
We identified 57,302 patients with GLF. The group had 34% men, with mean age of 68 years ± 17 years and injury severity score of 8 ± 5. Overall mortality was 3.2%. There were 32,320 elderly
patients (older than 70 years). The mortality in the elderly
was significantly higher than the nonelderly (4.4% vs. 1.6%, p
< 0.0001). The elderly
were more likely to sustain long-bone fracture (54.5% vs. 35.9%, p
< 0.0001), pelvic fracture (7.6% vs. 2.4%, p
< 0.0001), and intracranial injury (10.6% vs. 8.7%, p<0.0001). Multivariate analysis showed that Glasgow Coma Scale (GCS) score <15 (odds ratio, 4.98) and older than 70 years (odds ratio, 2.75) were significant predictors of mortality inpatients after GLF.
Patients older than 70 years and with GCS score <15 represent a group with significant inhospital mortality.