FATAL HEAD-INJURIES IN GROUND-LEVEL FALLS

We analyzed 75 cases of fatal ground-level falls that were investigate d by the King County Medical Examiner over a 48-month period, with aut opsies performed on 87% of the deaths: 69% of the cases were men and 6 1% occurred in ages greater than or equal to 70 years; only 12% were a ged <50 years, with the youngest aged 28 years. Most of the falls occu rred in or about the residence, and many individuals were known to hav e fallen onto hard surfaces. In 77% of cases there was significant pre -existing natural disease, mostly cardiovascular disease. Liver diseas e was more frequently a contributing factor in those aged <50 years. E thanol was present in 48% of those cases tested, more frequently prese nt in men than in women. Basal skull fractures were present in 37% of cases, and acute subdural hematomas, the mast common intracranial lesi on, were present in 85%. We concluded that fatal ground-level falls we re much more common in elderly persons, owing to a greater predisposit ion to falling, as well as intrinsic age-related changes, including a greater susceptibility to acute subdural hematoma.