Comparative analysis between identified injuries of victims of fall from height and other mechanisms of closed trauma

Parreira, José Gustavo; Matar, Marina Raphe; Tôrres, André Luis Barreto; Perlingeiro, Jacqueline A. G.; Solda, Silvia C.; Assef, José Cesar

doi:10.1590/0100-69912014004009

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Original Article • Rev. Col. Bras. Cir. 41 (4) • Jul-Aug 2014 • https://doi.org/10.1590/0100-69912014004009 copy

Comparative analysis between identified injuries of victims of fall from height and other mechanisms of closed trauma

Authorship SCIMAGO INSTITUTIONS RANKINGS

OBJECTIVE:

To analyze the lesions diagnosed in victims of falls, comparing them with those diagnosed in other mechanisms of blunt trauma.

METHODS:

We conducted a retrospective study of trauma protocol charts (prospectively collected) from 2008 to 2010, including victims of trauma over 13 years of age admitted to the emergency room. The severity of injuries was stratified by the Abbreviated Injury Scale (AIS) and Injury Severity Score (ISS). Variables were compared between the group of victims of falls from height (Group 1) and the other victims of blunt trauma (Group 2). We used the Student t, chi-square and Fisher tests for comparison between groups, considering the value of p <0.05 as significant.

RESULTS:

The series comprised 4,532 cases of blunt trauma, of which 555 (12.2%) were victims of falls from height. Severe lesions (AISe"3) were observed in the extremities (17.5%), in the cephalic segment (8.4%), chest (5.5%) and the abdomen (2.9%). Victims of Group 1 had significantly higher mean age, AIS in extremities / pelvis, AIS in the thoracic segment and ISS (p <0.05). The group 1 had significantly (p <0.05) higher incidence of tracheal intubation on admission, pneumothorax, hemothorax, rib fractures, chest drainage, spinal trauma, pelvic fractures, complex pelvic fractures and fractures to the upper limbs.

CONCLUSION:

Victims of fall from height had greater anatomic injury severity, greater frequency and severity of lesions in the thoracic segment and extremities.

Accidents; External Causes; Wounds and Injuries; Bone Fractures; Multiple Trauma

AIS Segment	1	2	3	4	5	Total

Head	25.4%	3.2%	3.2%	2.5%	2.7%	37.1%
Thorax	1.1%	2.3%	3.8%	1.3%	0.4%	8.8%
Abdomen	0.9%	0.9%	1.3%	0.9%	0.7%	4.7%
Extremities/pelvic bone	31.0%	11.2%	9.7%	4.7%	3.1%	59.6%

	Group 1 N=555			Group 2 N=3977			p

Age	41.25	± 17.54 anos		38.90	± 17.64 anos		0.007
SBP at admission	129.28	± 26.12 mmHg		128.29	± 22.09 mHg		0.342
HR at admission	83.47	± 14.64 bpm		82.93	± 13.77 bpm		0.405
RR at admission	17.40	±	4.74 ipm	17.43	±	4.17 ipm	0.882
GCS at admission	14.13	±	2.40	14.28	±	2.06	0.112
Sat Hb at admission	96.14	±	3.71	96.02	±	3.77	0.638
AIS head	0.65	±	1.15	0.66	±	1.07	0.761
AIS neck	0.01	±	0.17	0.009 ±		0.1	0.904
AIS thorax	0.23	±	0.82	0.13	±	0.63	0.001
AIS abdomen	0.13	±	0.68	0.10	±	0.60	0.292
AIS extremities	1.16	±	1.33	0.99	±	1.17	0.002
ISS	6.18	±	9.61	4.80	±	7.9	<0.001

	Group 1 N=555	Group 2 N=3977	p

Male gender	77.6%	76.0%	0.411
Alcohol breath at admission	8.1%	9.0%	0.500
OTI^* at admission	5.0%	3.1%	0.018
Chest Drainage at admission	2.7%	1.5%	0.039
Epidural Hematoma	2.5%	1.5%	0.069
Subdural Hematoma	2.3%	1.6%	0.193
Cerebral Contusion	4.1%	2.7%	0.060
Face Fracture	3.2%	4.7%	0.127
Spinal Trauma	4.1%	0.8%	< 0.001
Hemothorax	3.1%	1.6%	0.011
Pneumothorax	3.6%	1.5%	0.001
Rib Fractures	5.2%	3.0%	0.006
Pulmonary Contusion	2.7%	1.7%	0.082
Chest Drainage	3.6%	2.1%	0.028
Fracture of Pelvis	4.1%	1.4%	<0.001
Upper Limb Fracture	6.8%	4.9%	0.049
Lower Limb Fracture	5.9%	5.4%	0.619
Open Upper Limb Fracture	2.3%	0.9%	0.001
Open Lower Limb Fracture	1.4%	3.3%	0.019
Death	2.7%	2.0%	0.289
AIS⁺ cephalic > 3	8.4%	7.7%%	0.761
AIS⁺ thorax > 3	5.5%	3%	0.001
AIS⁺ abdomen > 3	2.9%	2.3%	0.292
AIS⁺ extremities > 3	17.5%	13.3%	0.002

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[1] Mailing address: José Gustavo Parreira E-mail: jgparreira@uol.com.br