title: Falls from ladders: age matters more than height.
abstract: BACKGROUND
  Falls from ladders account for a significant number of hospital visits. However, the epidemiology, injury pattern, and how age affects such falls are poorly described in the literature.
  
  
  METHODS
  Patients ≥18 y who suffered falls from ladders over a 5½-y period were identified in our trauma registry. Dividing patients into three age groups (18-45, 46-65, and >66 y), we compared demographic characteristics, clinical data, and outcomes including injury pattern and mortality. The odds ratios (ORs) were calculated with the group 18-45 y as reference; group means were compared with one-way analysis of variance.
  
  
  RESULTS
  Of 27,155 trauma patients, 340 (1.3%) had suffered falls from ladders. The average age was 55 y, with a male predominance of 89.3%. Average fall height was 9.8 ft, and mean Injury Severity Score was 10.6. Increasing age was associated with a decrease in the mean fall height (P < 0.001), an increase in the mean Injury Severity Score (P < 0.05), and higher likelihood of admission (>66 y: OR, 5.3; confidence interval [CI], 2.5-11.5). In univariate analysis, patients in the >66-y age group were more likely to sustain traumatic brain injuries (OR, 3.4; CI, 1.5-7.8) and truncal injuries (OR, 3.6; CI, 1.9-7.0) and less likely to sustain hand and/or forearm fractures (OR, 0.3; CI, 0.1-0.9).
  
  
  CONCLUSIONS
  Older people are particularly vulnerable after falling from ladders. Although they fell from lower heights, the elderly sustained different and more severe injury patterns. Ladder safety education should be particularly tailored at the elderly.
authors: Department of Surgery, West Virginia University, Morgantown, West Virginia. Electronic address: jocon@hsc.wvu.edu.
authors: Jorge
authors: J
authors: Con
authors: Department of Surgery, University of Arizona, Tucson, Arizona.
authors: Randall S
authors: RS
authors: Friese
authors: Department of Biostatistics, West Virginia University, Morgantown, West Virginia.
authors: Dustin M
authors: DM
authors: Long
authors: Department of Surgery, University of Arizona, Tucson, Arizona.
authors: Bardiya
authors: B
authors: Zangbar
authors: Department of Surgery, University of Arizona, Tucson, Arizona.
authors: Terence
authors: T
authors: O'Keeffe
authors: Department of Surgery, University of Arizona, Tucson, Arizona.
authors: Bellal
authors: B
authors: Joseph
authors: Department of Surgery, University of Arizona, Tucson, Arizona.
authors: Peter
authors: P
authors: Rhee
authors: Department of Surgery, University of Arizona, Tucson, Arizona.
authors: Andrew L
authors: AL
authors: Tang
mesh_terms: D000058:Accidental Falls; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001827:Body Height; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D007902:Length of Stay; D008297:Male; D008875:Middle Aged
keywords: Extremity fractures; Fall from ladder; Geriatric trauma; Head injuries; Truncal injuries