• Panagiotis Kyriakou Liasidis, Cameron Ghafil, Morgan Schellenberg, Kazuhide Matsushima, Valerie Ponning Huang, Lydia Lam, Demetrios Demetriades, and Kenji Inaba.
• Division of Trauma and Surgical Critical Care, Department of Surgery, Los Angeles County and University of Southern California Medical Center, Keck School of Medicine of the University of Southern California, 2051 Marengo Street, IPT, CSL 100, Los Angeles, CA, 90033, USA.
• Eur J Trauma Emerg Surg. 2023 Apr 1; 49 (2): 813823813-823.

IntroductionFalls from scaffolds are a common cause of occupational injuries and fatalities, however, the data concerning these injuries are scarce. The purpose of this study was to characterize the epidemiology, injury patterns, and outcomes of falls from scaffolds.MethodsRetrospective cohort study using data from the National Trauma Data Bank (2007-2017). All adult patients who sustained injuries following falls from scaffolds and as a comparator, falls from ladders, were identified using the external cause of injury codes. The primary outcome was differences in the type and severity of injuries between the groups.ResultsA total of 183,853 patients were analyzed. Of these, 18,189 (9.9%) fell from scaffolds and 165,664 (90.1%) from ladders. Patients who fell from scaffolds were younger, more often male, and more likely to sustain severe trauma (ISS > 15: 24.1% vs 17.3%, p < 0.001). Falls from scaffolds resulted in more severe head injuries (head AIS ≥ 3: 18.6% vs 14.7%, p < 0.001) and more spinal fractures (30.3% vs 25.2%, p < 0.001). Falls from scaffolds were associated with higher mortality (2.5% vs 1.8%, p < 0.001), higher ICU admission rate (25.0% vs 21.5%, p < 0.001), and longer hospitalization. On multivariable analysis, the strongest predictors of mortality were GCS < 9 and hypotension on admission, severe (AIS ≥ 3) head injury, and age > 65 years.ConclusionFalls from scaffolds are associated with more severe injuries and worse outcomes compared to ladder falls. Males in the fourth decade of life were disproportionally affected. Further research on fall prevention is warranted to decrease this important cause of death and disability.© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.

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