Factors effecting mortality in urban vertical free falls: evaluation of 180 cases

Aim: The aim of this retrospective study was to evaluate the factors on mor tality in urban free vertical falls. Patients and Methods: A total of 180 urban vertical free fall victims who s urvived transport to the emergency room between the period of 1980-1998 wer e evaluated. Minor bruises, abrasions, haematomas, and soft tissue injuries were not encountered. Serious injuries such as bone fractures, liver lacer ations, epi-subdural haematomas, haemothorax, haemomediastinum, retroperito neal haematomas were evaluated. Results: Of the total, 23% (n = 41) of patients were female and 73% (n = 13 9) were male. The mean age was 22.3 years (4-75 years). Extremity fractures were found in 6.7% (n = 12), cranial trauma in 14.4% (n = 26), thoracic tr auma in 2.2% (n = 4) retroperitoneal trauma in 2.8% (n = 5), vertebral colu mn trauma in 1.7% (n = 3) of cases. The overall number of the pathologies w as 59. In-hospital mortality was 8.9% (n = 16). The injury severity scores (ISSs) of non-survivors and survivors were 33 +/- 4, and 5 +/- 0.6, respect ively (P = 0.0001). The heights fallen were 8.6 +/- 2.3 m for non-survivors and 5.2 +/- 0.2 m for survivors (P = 0.022). The mean ages of non-survivor s and survivors were 41.6 +/- 5.9 years and 20.4 +/- 1.2 years, respectivel y (P = 0.003). Serious cranial trauma was found in 68.7% (n = 11) and 9.1% (n = 5) of non-survivors and survivors, respectively (P = 0.0001). Extremit y trauma was encountered in 31.2% (n = 5) and 4.2% (n = 7) of non-survivors and survivors, respectively (P = 0.0015). The ISSs were 6.8 +/- 1.0 and 8. 9 +/- 1.1 for cases under the age of 6 years and others, respectively (P = 0.15). Using logistic regression analysis, ISS, height and age were found t o be significant factors in mortality. Conclusion: Vertical deceleration injury represents a distinct form of trau ma. With the results of this study, it can be concluded that ISS, height an d age are significant factors in determining the severity of trauma.