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Ann Fr Anesth Reanim · Jul 2004
[Victims of fall from height. Study of 287 patients and determination of clinical prognostic factors].
- F Lapostolle, S W Borron, C Gere, F Dallemagne, A Beruben, C Lapandry, M Galinski, and F Adnet.
- Samu 93, EA34-09, hôpital Avicenne, 125, rue de Stalingrad, 93009 Bobigny, France. frederic.lapostolle@avc.ap-hop-paris.fr
- Ann Fr Anesth Reanim. 2004 Jul 1;23(7):689-93.
IntroductionFall from height is a common cause of severe blunt urban trauma but this mechanism of trauma is poorly documented.ObjectiveTo describe initial clinical parameters, injuries and outcome in patients victims of falls from height and to determinate clinical prognostic factors.Study DesignRetrospective 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.Patients And MethodsStudied 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.ResultsTwo 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).ConclusionImmediate mortality after fall from heights is high and remains low after day 3. GCS, ABP and RTS are independent prognostic factors.
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