Can the distance fallen predict serious injury after a fall from a height?

Background: After a fall, the distance fallen is sometimes used to predict the injury severity. We aimed to examine how distance fallen performs as a predictor of major injury. Method: A cohort of trauma victims attending our emergency department after having fallen from a height was identified retrospectively, and data were collected regarding the fall and injuries sustained. Performance of thresho ld heights, ranging from 2 meters (6.6 feet) to 10 meters (32.8 feet), as a diagnostic test for major injury was assessed. Results: Height fallen performed poorly over the range of thresholds used. At low thresholds, sensitivity was inadequate to rule out major trauma, whe reas the low prevalence meant that, despite impressive specificity at highe r thresholds, positive pre dictive value was poor. At the optimal threshold of 5 meters (16.4 feet), the positive predictive value was 0.17 and sensit ivity was 0.33, Conclusion: Height of fall is a poor predictor of major injury.