Alcohol related falls: an interesting pattern of injuries.
OBJECTIVE
To discover if there is a significant difference in the pattern and severity of injury sustained during falls in patients who have consumed alcohol and those who have not. To determine how pattern and severity of injury correlates with blood alcohol concentration.


METHODS
A prospective quasi-randomised controlled study between November 2001 and July 2002. All healthy adults between 16 and 60 years who had fallen from standing height were included. A systematic history and examination permitted calculation of injury severity scores as per abbreviated injury scale update 1998. Blood alcohol concentrations were obtained from intoxicated patients with consent.


RESULTS
351 healthy adult patients were included in the study, there were 238 in the no alcohol group, 113 had consumed alcohol and blood alcohol intake were obtained for 47. The alcohol group had a higher incidence of head injuries (46 (48%) versus 22 (9%)) with a lower incidence of limb injuries (39 (39%) versus 183 (76%)) than the no alcohol group. There was a significant difference in the pattern of injury between the alcohol and no alcohol groups (chi(2), p<0.001) and there was a significant difference in the injury severity scores (p<0.001, Z = -2.5). In the alcohol group severity and pattern correlated with alcohol concentration at the time of injury. Patients with an alcohol concentration<2 g/l had mostly soft tissue limb injuries (58%), 2-2.5 mostly significant limb fractures (55%), and >2.5 mostly significant head injuries (90%).


CONCLUSIONS
Alcohol related falls are more often associated with severe craniofacial injury. The severity of both limb and head injury is greater and correlates directly with blood alcohol concentration.
Johnston
J J E
JJ
Accident and Emergency Department, The Ulster Hospital Dundonald, Northern Ireland. jeremyjejohnston@doctors.org.uk <jeremyjejohnston@doctors.org.uk>
McGovern
S J
SJ
D000058:Accidental Falls; D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000097:blood*; D001134:Arm Injuries / Q000097:blood / Q000209:etiology; D006259:Craniocerebral Trauma / Q000097:blood / Q000209:etiology; D000431:Ethanol / Q000097:blood; D050723:Fractures, Bone / Q000097:blood / Q000209:etiology; D006801:Humans; D007869:Leg Injuries / Q000097:blood / Q000209:etiology; D008875:Middle Aged; D011446:Prospective Studies; D017695:Soft Tissue Injuries / Q000097:blood / Q000209:etiology; D015599:Trauma Severity Indices; D014947:Wounds and Injuries / Q000097:blood / Q000209:etiology*
D000431:Ethanol