M. Aufmkolk et al., Injuries due to falls from a considerable height. A comparative analysis from injuries and clinical course after international or accidental fall, UNFALLCHIRU, 102(7), 1999, pp. 525-530
The aim of this study was to compare the outcome and clinical course of mul
tiple trauma patients with accidental or intentional (suicide related) fall
from heights > 4 m. 211 patients with an injury severity score (ISS) > 17
were assigned to the following groups: I: intentional fall, n = 94; A: acci
dental fall, n = 117) and ISS (1: 28 +/- 1; A: 30 +/- 1), ventilation time
(1: 16 +/- 2; A: 15 +/- 1) were not different. Significant differences were
found in sex (m/f: I: 56/44; A: 73/27 %), fractures of lumbarspine (I: 34;
A: 15 %), pelvis (I: 51; A: 38 %), lower leg (I: 47; A: 20 %), pilon (I: 1
5; A: 5 %), and os calcis (I: 17; A: 9%). Liver lacerations occured more of
ten after intentional fall (I: 16; A: 6 %). Single or multiple organ failur
e (MOF) was diagnosed significantly more often in group A (I: 1; A: 8 %). M
ain cause of death in both groups was single or multiple organ failure (MOF
: 1: 47; A: 69 %) or related to brain-injuries (I: 35; A: 19%). Prognosis a
nd rehabilitation of multiple trauma patients after intentional fall is rel
ated to brain-injuries, spine-fractures and the functional outcome of the i
njured lower leg. Prognosis of patients after accidental fall is related to
the development of MOF during the ICU-course.