Archives of emergency medicine
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During a recent 4-year period, 381 patients were admitted with injuries sustained from falls. Equal numbers of patients were less than and greater than 50 years of age and included 53 children (less than or equal to 16 years) and 214 elderly (greater than or equal to 55 years). Falls from heights occurred predominantly in young males (mean age 34.2 years), were most commonly job or recreation related and resulted in higher injury severity scores (ISS). ⋯ In patients under 55 years, deaths resulted from fall-related central nervous system (CNS) injury and/or multisystem trauma. In patients over 55 years, fatalities were most commonly related to pre-existent medical conditions. Based on a review of this experience, we conclude that: (1) unlike other causes of blunt and penetrating trauma, both sexes are equally at risk from fall-related injuries but sex incidence is age related; (2) falls from heights are more common in men; (3) advanced age and pre-existing medical conditions account for the increased morbidity and mortality following falls and; (4) cost containment measures for fall-related trauma must consider not only injury severity, but the age and pre-existent medical conditions of the patient.
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Elbow injuries are commonly seen in accident departments. Patients with possible bony injuries to the elbow were assessed to see if inability to fully extend the elbow was a good indicator of bony injury and hence the need for X-ray. The sensitivity of this test was 90.7% (95% confidence limits 80.7-100.7) and the specificity 69.5% (95% confidence limits 60.3-78.7). Use of this simple test would reduce both radiography costs and unnecessary exposure to radiation.