Injuries due to falls from a considerable height. A comparative analysis from injuries and clinical course after international or accidental fall

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.