Factors associated with the injury severity of falls from a similar height and features of the injury site in Korea: a retrospective study.

Journal of Trauma and Injury Pub Date : 2023-09-01 Epub Date: 2022-11-16 DOI:10.20408/jti.2022.0042
Dae Hyun Kim, Jae-Hyug Woo, Yang Bin Jeon, Jin-Seong Cho, Jae Ho Jang, Jea Yeon Choi, Woo Sung Choi
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Abstract

Purpose: This study aimed to determine the risk factors associated with the severity of fall-related injuries among patients who suffered a fall from similar heights and analyze differences in injury sites according to intentionality and injury severity.

Methods: The Emergency Department-based Injury In-depth Surveillance (EDIIS) data collected between 2019 and 2020 were used in this retrospective study. Patients with fall-related injuries who fell from a height of ≥6 and <9 m were included. Patients were categorized into the severe and mild/moderate groups according to their excessive mortality ratio-adjusted Injury Severity Score (EMR-ISS) and the intention and non-intention groups. Injury-related and outcome-related factors were compared between the groups.

Results: In total, 33,046 patients sustained fall-related injuries. Among them, 543 were enrolled for analysis. A total of 256 and 287 patients were included in the severe and mild/moderate groups, respectively, and 93 and 450 patients were included in the intention and non-intention groups, respectively. The median age was 50 years (range, 39-60 years) and 45 years (range, 27-56 years) in the severe and mild/moderate groups, respectively (P<0.001). In multivariable analysis, higher height (odds ratio [OR] 1.638; 95% confidence interval [Cl], 1.279-2.098) and accompanying foot injury (OR, 0.466; 95% CI, 0.263-0.828) were independently associated with injury severity (EMR-ISS ≥25) and intentionality of fall (OR, 0.722; 95% CI, 0.418-1.248) was not associated with injury severity. The incidence of forearm injuries was four (4.3%) and 58 cases (12.9%, P=0.018) and that of foot injuries was 20 (21.5%) and 54 cases (12.0%, P=0.015) in the intention versus non-intention groups, respectively.

Conclusions: Among patients who fell from a similar height, age, and fall height were associated with severe fall-related injuries. Intentionality was not related to injury severity, and patients with foot injury were less likely to experience serious injuries. Injuries in the lower and upper extremities were more common in intentional and unintentional falls, respectively.

与从相似高度和损伤部位特征坠落的损伤严重程度相关的因素:一项回顾性研究
目的:本研究旨在确定从相似高度坠落的患者中与坠落损伤严重程度相关的危险因素,并根据意向性和损伤严重程度分析损伤部位的差异。方法:采用2019 - 2020年急诊损伤深度监测(EDIIS)数据进行回顾性研究。包括从≥6 m和<9 m高度坠落的跌倒相关损伤患者。根据过度死亡率调整的损伤严重程度评分(EMR-ISS)及有意组和非有意组将患者分为重度组和轻/中度组。比较两组间损伤相关因素和预后相关因素。结果:共有33046例患者发生跌倒相关损伤。其中543例纳入分析。重度组和轻度/中度组分别有256例和287例患者,有意组和非有意组分别有93例和450例患者。重度组和轻度/中度组的中位年龄分别为50岁(范围39 ~ 60岁)和45岁(范围27 ~ 56岁)(P<0.001)。在多变量分析中,较高的身高(比值比[OR] 1.638;95%可信区间[Cl], 1.279-2.098)及伴随的足部损伤(OR, 0.466;95% CI, 0.263-0.828)与损伤严重程度(EMR-ISS≥25)和跌倒的意向性独立相关(OR, 0.722;95% CI(0.418-1.248)与损伤严重程度无关。有意组与非有意组前臂损伤发生率分别为4例(4.3%)和58例(12.9%,P=0.018),足部损伤发生率分别为20例(21.5%)和54例(12.0%,P=0.015)。结论:在从相似高度坠落的患者中,年龄和坠落高度与严重的坠落相关损伤有关。意向性与损伤严重程度无关,足部损伤患者发生严重损伤的可能性较小。下肢和上肢损伤分别在有意和无意跌倒中更为常见。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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