[Victims of fall from height. Study of 287 patients and determination of clinical prognostic factors].
BACKGROUND
Fall from height is a common cause of severe blunt urban trauma but this mechanism of trauma is poorly documented.


OBJECTIVE
To describe initial clinical parameters, injuries and outcome in patients victims of falls from height and to determinate clinical prognostic factors.


METHODS
Retrospective study from January 1998 to May 1999 and prospective study from June 1999 to September 2000. Inclusions: patients older than 12 year-old victims of falls with height of more than 3 m.


METHODS
Studied parameters: demographic data, fall circumstances, prehospital clinical evaluation (Glasgow coma scale (GCS), Arterial Blood Pressure (ABP), Heart Rhythm (ER) and revised trauma score (RTS) initial and patients outcome.


RESULTS
Two hundred and eighty seven patients were included during 32.5 months; 33% were women and 67% men. Mean age: 37 +/- 16 years. Median height of fall: three stairs (3-4). Final mortality: 34% including 22% death on site with or without resuscitation, 5% before hospitalization, 8% during the first day and 2% later. Independent prognostic factors were GCS (OR = 0.40; IC: 0.25 - 0.65; P = 0.0002), initial ABP (OR = 0.94; IC: 0.90 - 0.98; P = 0.008) and RTS (OR = 2.93; 1.19-7.24; P = 0.02).


CONCLUSIONS
Immediate mortality after fall from heights is high and remains low after day 3. GCS, ABP and RTS are independent prognostic factors.
Samu 93, EA34-09, hôpital Avicenne, 125, rue de Stalingrad, 93009 Bobigny, France. frederic.lapostolle@avc.ap-hop-paris.fr
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Lapostolle
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Borron
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Gere
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Dallemagne
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Beruben
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Lapandry
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Galinski
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Adnet
D000058:Accidental Falls / Q000401:mortality / Q000706:statistics & numerical data*; D000328:Adult; D001794:Blood Pressure / Q000502:physiology; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome; D014949:Wounds, Nonpenetrating / Q000209:etiology / Q000628:therapy