Fall from heights: does height really matter?

Fall from heights is high energy injuries and constitutes a fraction of all fall-related trauma evaluations while bearing an increase in morbidity and mortality. We hypothesize that despite advancements in trauma care, the overall survivability has not improved in this subset of trauma patients. All adult trauma patients treated after sustaining a fall from heights during a 40-month period were retrospectively reviewed. Admission demographics, clinical data, fall height (ft), injury patterns, ISS, GCS, length of stay, and mortality were reviewed. 116 patients sustained a fall from heights, 90.4% accidental. A mean age of 37 +/- 14.7 years, 86% male, and a fall height of 19 +/- 10 ft were encountered. Admission GCS was 13 +/- 2 with ISS 10 +/- 11. Overall LOS was 6.6 +/- 14.9 days and an ICU LOS of 2.8 +/- 8.9 days. Falls ae 25 ft.(16%) had lower GCS 10.4 +/- 5.8, increased ISS 22.6 +/- 13.8, a fall height 37.9 +/- 13.1 ft and associated increased mortality (p < 0.001). Mortality was 5.2%, a mean distance fallen of 39 +/- 22 ft. and an ISS of 31.5 +/- 16.5. Brain injury was the leading cause of death, 50% with open skull fractures. Level of height fallen is a good predictor of overall outcome and survival. Despite advances in trauma care, death rates remain unchanged. Safety awareness and injury prevention programs are needed to reduce the risk of high-level falls.