title: Review of morbidity and mortality associated with falls from heights among patients presenting to a major trauma centre.
abstract: OBJECTIVE
  To compare differences in demographics and injuries of patients presenting after falls from heights at home and at work.
  
  
  METHODS
  A retrospective case series review of patients treated by the Royal Adelaide Hospital (RAH) Trauma Service following a fall from a ladder, scaffold, building, or tree between July 2000 and December 2003.
  
  
  RESULTS
  Two hundred and eighty-two patients fulfilled study criteria. The 162 (57.4%, 95% confidence interval [CI] 48.9-60.5) injured at home were significantly (P < 0.001) older (mean age 53.9 years, 95% CI 51.3-56.7) than those injured at work (mean age 41.2 years, 95% CI 38.6-43.8). Injury severity score (ISS) was similar in the two groups. Those injured at home were more likely to be admitted to hospital and have significantly longer hospital stays (P = 0.003). Thirteen deaths were recorded, eight (61.5%) from home, all over 49 years old. Ladders were implicated in seven (53.8%, 95% CI 26.7-80.9) of the deaths. A 67% (95% CI 55.4-79.0) increase in the number of presentations following falls at home over the study period was significantly greater than the 12.2% (95% CI 10.7-13.7) increase in total trauma presentations during this time (P = 0.0007).
  
  
  CONCLUSIONS
  Injuries resulting from falls at home are increasing. This group tends to be elderly and at risk of significant injury and prolonged hospital stays. Causes are multifactorial and might be related to increased popularity of home renovations. Ladders are implicated in many of these accidents. As emergency physicians we should target this population to educate them in safe ladder use.
authors.affiliation: Emergency Department, Royal Adelaide Hospital, North Terrace, Adelaide, South Australia, Australia. doc17@mac.com
authors.forename: Alison
authors.initials: A
authors.lastname: Kent
authors.forename: Andrew
authors.initials: A
authors.lastname: Pearce
mesh_terms: D000007:Abdominal Injuries / Q000453:epidemiology; D000058:Accidental Falls / Q000401:mortality / Q000706:statistics & numerical data*; D000061:Accidents, Home / Q000401:mortality / Q000706:statistics & numerical data; D000062:Accidents, Occupational / Q000401:mortality / Q000706:statistics & numerical data; D000328:Adult; D017677:Age Distribution; D015984:Causality; D003288:Contusions / Q000453:epidemiology; D006259:Craniocerebral Trauma / Q000453:epidemiology; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D017678:Sex Distribution; D013021:South Australia / Q000453:epidemiology; D013124:Spinal Injuries / Q000453:epidemiology; D016019:Survival Analysis; D014947:Wounds and Injuries / Q000145:classification / Q000453:epidemiology*