Analysis of serious injuries caused by stairway falls

Abstract

Objective: To study the demographics of patients who sustained serious injuries from falling down stairs. Method: This study is a retrospective analysis of all patients who presented to an urban hospital with an injury severity score of equal to or greater than 16 after falling down stairs during the period January 1992 to December 1996. Patient demographics, stair location and number, severity and anatomical nature of injuries, serum ethanol levels, patient referral characteristics and mortality rates were examined. Results: A total of 113 patients were studied; 74% were male. Sixty‐five per cent of falls occurred at the patient’s place of residence. Ethanol may have been a contributing factor in 55% of injuries. Ninety‐five per cent of victims had an injury severity score of equal to or less than 30. Head injuries were common with acute subdural haematoma occurring in 57% of patients. Head‐injured patients had a significantly higher mortality rate than non‐head‐injured patients (P = 0.02). Increasing age and higher injury severity score correlated with poor outcome in all patients. Thirty‐nine of the 113 stairway‐fall patients (35%) died in hospital compared with 207 of 1091 non‐stairway‐fall patients (19%) during the same period (P < 0.001). Conclusion: In the adult population, falls down stairs may result in serious injuries, particularly head trauma. In the present study, this group of patients had a significantly higher mortality than other trauma patients.

Falling down a flight of stairs: The impact of age and intoxication on injury pattern and severity

“…Patients most at risk from this mechanism are either older patients or younger people who are intoxicated, each scenario providing unique diagnostic and management challenges. 1 – 5 Older patients are more likely to have significant injuries despite a low risk mechanism, while the presence of comorbidities increases their risk of mortality despite a lower injury severity. 6 Intoxicated patients also provide a diagnostic challenge, as physical examination is often unreliable.…”

Stair-Related Injuries to Young Children Treated in US Emergency Departments, 1999–2008

“…Subanalyses were conducted on humerus and femur fractures. NEISS categories for type of injury were regrouped into (1) dislocations, (2) fractures, (3) closed head injuries (including concussions and intracranial hemorrhages), (4) soft tissue injuries (including sprains, strains, hematomas, and contusions), (5) lacerations (including puncture wounds), and (6) miscellaneous. Disposition from the ED was categorized as (1) released (patients who were treated and released or left the ED without treatment) or (2) hospitalized (patients who were admitted, transferred to another hospital, or held for observation).…”

“…Although there is extensive literature on stair-related injuries as a major cause of mortality and morbidity among older adults, [1][2][3][4] little has been published on stair-related injuries among young children. An emergency department (ED)-based study showed that stairs were among the top 10 causes of injury to children aged ,1 year during each month of life and that the incidence of those injuries rose as infant mobility increased, with stairs being the most common cause of injury at 12 months of age.…”

The circumstances and characteristics of fatal falls in Victoria, Australia: a descriptive study

“…Substance effects have been linked to a variety of fall types due to their ability to impair an individual's thinking and balance and thus cause them to jump or slip/trip 65 . The types of falls with substance-affected cases in this study are predominantly high falls, which have also commonly been associated with individuals who suicide from heights 5,7 , however they are not strongly associated with falls down stairs as previously documented 16,17,66 . This suggests there are other means of impaired balance, such as physical conditions, that are potentially a greater risk contributor for stair falls in Victorian residents.…”