Journal of Trauma and Injury

The Korean Society of Traumatology (대한외상학회)
권호 표지

The Prognostic Significance of Injury Severity Score and Height of Fall in Free Fall Patients

추락환자의 예후인자로서 외상지수와 추락높이의 의의

  • Seo, Kyung-Su (Department of Surgery, Postgraduate School of Medicine, Gyeongsang National University) ;
  • Park, Soon-Tae (Department of Surgery, Postgraduate School of Medicine, Gyeongsang National University) ;
  • Ha, Woo-Song (Department of Surgery, Postgraduate School of Medicine, Gyeongsang National University) ;
  • Choi, Sang-Kyung (Department of Surgery, Postgraduate School of Medicine, Gyeongsang National University) ;
  • Hong, Soon-Chan (Department of Surgery, Postgraduate School of Medicine, Gyeongsang National University) ;
  • Lee, Young-Joon (Department of Surgery, Postgraduate School of Medicine, Gyeongsang National University) ;
  • Jung, Eun-Jung (Department of Surgery, Postgraduate School of Medicine, Gyeongsang National University) ;
  • Jeong, Chi-Young (Department of Surgery, Postgraduate School of Medicine, Gyeongsang National University) ;
  • Jeong, Sang-Ho (Department of Surgery, Postgraduate School of Medicine, Gyeongsang National University) ;
  • Ju, Young-Tae (Department of Surgery, Postgraduate School of Medicine, Gyeongsang National University)
  • 서경수 (경상대학교 의과대학 외과학교실) ;
  • 박순태 (경상대학교 의과대학 외과학교실) ;
  • 하우송 (경상대학교 의과대학 외과학교실) ;
  • 최상경 (경상대학교 의과대학 외과학교실) ;
  • 홍순찬 (경상대학교 의과대학 외과학교실) ;
  • 이영준 (경상대학교 의과대학 외과학교실) ;
  • 정은정 (경상대학교 의과대학 외과학교실) ;
  • 정치영 (경상대학교 의과대학 외과학교실) ;
  • 정상호 (경상대학교 의과대학 외과학교실) ;
  • 주영태 (경상대학교 의과대학 외과학교실)
  • Received : 2009.02.26
  • Accepted : 2009.06.26
  • Published : 2009.06.30
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: In this study, the prognostic significance of the Injury Severity Score (ISS) and the height of fall in free-fall patients were investigated. Methods: The medical records of 179 victims of falls from a height who were brought alive to the Emergency Department of Gyeongsang National University Hospital between January 2003 and December 2007 were analyzed. The age, the sex of the patients, the rate of admission, the hospital stay, the site of injury, the severity of injury, the rate of surgery, the site of the fall and the presence of alcohol intoxication were evaluated by using a retrospective review of the medical records. Injury severity was measured by using the ISS. Patients were categorized into four subgroups according to the height from where they had fallen. The data were statistically analyzed with using SPSS ver. 10.0. Results: The admission rates for the subgroups with falls of less than 3 stories were significantly lower than those for the subgroups with higher heights of falls (70.7% vs. 100%, p<0.05). These two subgroups showed statistically significant differences in mean hospital stay ($17.11{\pm}24.88$ vs. $56.73{\pm}49.21$, p<0.05), rate of operation (30.6% vs. 53.8%, p<0.05), and mean ISS ($6.86{\pm}4.97$ vs. $13.96{\pm}9.14$, p<0.05). In the correlation analysis, the ISS and the mean hospital stay showed the highest correlation with correlation coefficient of 0.666. Conclusion: In this retrospective analysis of 179 free-fall patients, we evaluated the prognostic factors affecting the outcomes for the free-fall patients. The patients who had fallen from heights of 3 stories or higher showed statistically significant higher rates of admission, longer durations of hospital stay, higher ISSs, and higher operation rates. The most accurate factor in predicting the length of hospital stay was the ISS.

Keywords

References

  1. Mathers LJ, Weiss HB. Incidence and characteristics of fall-relate emergency department visits. Acad Emerg Med 1998;5(11):1064-70 https://doi.org/10.1111/j.1553-2712.1998.tb02663.x
  2. Jeong SP, Jeong SW, Jeong HS, Whang TS, Jang MJ, Lee HS. Factors affection to injury severity of Free-fall patients. J Korean Soc Emerg Med 1999;10(1):85-90
  3. Baker SP, O'Neill B, Jaddon W, Long WB. The injury severity score: A method fordescribing patients with multiple injuries and evaluation emergency care. J Trauma 1974;14:187 https://doi.org/10.1097/00005373-197403000-00001
  4. Ko YK. Traumatology. 1st ed. Seoul:Koonja;2001
  5. Jeong JK, Lee HW, Lyu BY, Kim HK, Seock H, Choi CS. A clinical significance of the trauma scoring system on the patient with multiple injury. J Korean Surg Soc 1995;49(6):840-848
  6. Linn S. The injury severity score-importance and uses. Ann Epidemiol 1995;5(6):440-6 https://doi.org/10.1016/1047-2797(95)00059-3
  7. Kingma J. Ten Duis, HJ. Severity of injuries due to accidental fall across the life span : a retrospective hospital-based study. Percept Mot Skills. 2000;90(1):62-72 https://doi.org/10.2466/PMS.90.1.62-72
  8. Atanasijevic T, Nikolic S, Djokie V. Level of total injury severity as a possible parameter for evaluation of height in fatal falls. Srp Arh Celok Lek 2004;132(3-4):96-8 https://doi.org/10.2298/SARH0404096A
  9. Goodacre S, Than M, Goyder EC. Joseph AP. Can the distance fallen predict serious injury after a fall from a height? J Trauma 1996;46:1055-1058 https://doi.org/10.1097/00005373-199906000-00014
  10. Lapostolle F, Gere C, Borron SW, Petrovic T, Callemagne F, Beruben A et al. Prognostic factors in victims of falls from height. Crit Care Med 2005;33(6):1239-42 https://doi.org/10.1097/01.CCM.0000164564.11989.C3
  11. Velmahos GC, Demetriades D, Theodorou D, Belzberg H, Asensio J, Murray J. et al. Patterns of injury in victims of urban Free-fall. World J Surg 1997;21(8):816-20 https://doi.org/10.1007/s002689900312
  12. Ong A, Lau PT, Yeo AW, Koh MP, Lau G. Victims of falls from a height surviving to hospital admission in two Singapore hospitals. Med Sci Law. 2004;44(3):201-6 https://doi.org/10.1258/rsmmsl.44.3.201
  13. Hingson R, Howland J. Alcohol as a risk factor for injury or death resulting from accidental falls : A review of the literature. J Stud Alcohol 1987;48:212-9