Impact of ladder‐related falls on the emergency department and recommendations for ladder safety

Cabilan, C.J.; Vallmuur, Kirsten; Eley, Robert; Judge, Chantelle; Cochrane, Sarah; Reed, Connie; Riordan, Jessica; Roberts, Kym; Thom, Ogilvie; Wood, G. D.

doi:10.1111/1742-6723.12854

Cited by 14 publications

(45 citation statements)

References 21 publications

(60 reference statements)

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“…High falls accounted for 17% of all cases of TSCI, nearly half of which were from a ladder or roof. The incidence of ladder falls is increasing, and interventions that encourage avoiding risk, using safety equipment, and improving ladder setup have been recommended …”

Section: Discussionmentioning

confidence: 99%

Traumatic spinal cord injury in Victoria, 2007–2016

Beck

Cameron

Braaf

et al. 2019

Medical Journal of Australia

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Objective To investigate trends in the incidence and causes of traumatic spinal cord injury (TSCI) in Victoria over a 10‐year period. Design, setting, participants Retrospective cohort study: analysis of Victorian State Trauma Registry (VSTR) data for people who sustained TSCIs during 2007–2016. Main outcomes and measures Temporal trends in population‐based incidence rates of TSCI (injury to the spinal cord with an Abbreviated Injury Scale [AIS] score of 4 or more). Results There were 706 cases of TSCI, most the result of transport events (269 cases, 38%) or low falls (197 cases, 28%). The overall crude incidence of TSCI was 1.26 cases per 100 000 population (95% CI, 1.17–1.36 per 100 000 population), and did not change over the study period (incidence rate ratio [IRR], 1.01; 95% CI, 0.99–1.04). However, the incidence of TSCI resulting from low falls increased by 9% per year (95% CI, 4–15%). The proportion of TSCI cases classified as incomplete tetraplegia increased from 41% in 2007 to 55% in 2016 (P < 0.001). Overall in‐hospital mortality was 15% (104 deaths), and was highest among people aged 65 years or more (31%, 70 deaths). Conclusions Given the devastating consequences of TSCI, improved primary prevention strategies are needed, particularly as the incidence of TSCI did not decline over the study period. The epidemiologic profile of TSCI has shifted, with an increasing number of TSCI events in older adults. This change has implications for prevention, acute and post‐discharge care, and support.

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Section: Discussionmentioning

confidence: 99%

Traumatic spinal cord injury in Victoria, 2007–2016

Beck

Cameron

Braaf

et al. 2019

Medical Journal of Australia

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“…This study [1] found older adults who use ladders in non-occupational settings such as the home are the highest risk group for injury from a ladder fall which has been a similar finding in other studies [2,3]. Studies have shown simple safety measures such as setting up and stabilising the ladder correctly, wearing appropriate footwear and not overreaching on the ladder are not being practiced in the home setting [1][2][3]. Previous research has focused on the incidence of these falls and immediate patient outcomes [2,[4][5][6][7][8][9][10][11].…”

Section: Introductionmentioning

confidence: 87%

“…Ladder-related falls are a frequently preventable burden of injury. The rate of ladder-related falls is increasing with many patients presenting to emergency departments (EDs) with serious injuries [1,2]. We have previously published a paper where a customised questionnaire to was used to establish the characteristics of the participants who experienced a ladder-related fall and the impact of these falls in the ED [1].…”

Section: Introductionmentioning

confidence: 99%

“…The rate of ladder-related falls is increasing with many patients presenting to emergency departments (EDs) with serious injuries [1,2]. We have previously published a paper where a customised questionnaire to was used to establish the characteristics of the participants who experienced a ladder-related fall and the impact of these falls in the ED [1]. This study [1] found older adults who use ladders in non-occupational settings such as the home are the highest risk group for injury from a ladder fall which has been a similar finding in other studies [2,3].…”

Section: Introductionmentioning

confidence: 99%

“…We have previously published a paper where a customised questionnaire to was used to establish the characteristics of the participants who experienced a ladder-related fall and the impact of these falls in the ED [1]. This study [1] found older adults who use ladders in non-occupational settings such as the home are the highest risk group for injury from a ladder fall which has been a similar finding in other studies [2,3]. Studies have shown simple safety measures such as setting up and stabilising the ladder correctly, wearing appropriate footwear and not overreaching on the ladder are not being practiced in the home setting [1][2][3].…”

Section: Introductionmentioning

confidence: 99%

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Long term impact of ladder-related injuries as measured by the AQoL instrument

et al. 2020

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Introduction Ladder-related falls are a common cause of patients presenting to emergency departments (ED) with serious injury. The impacts of ladder-related injuries were assessed at six-months post-injury using the quality of life, AQoL 4D Basic (AQoL) instrument. Materials and methods This was a prospective observational study, conducted and reported according to the STROBE statement. All adult patients with ladder-related injuries who presented to two EDs in southeast Queensland, Australia between October 2015 and October 2016 were approached. Initial participant interviews took place at the time of ED presentation or shortly thereafter, with follow-up telephone interview at six-months. Results There were 177 enrolments, 43 (24%) were lost to follow up. There were statistically significant changes post-injury for three of the four AQoL dimensions: independence, social relationships and psychological wellbeing, as well as the global AQoL. Twenty-four (18%) participants reported a clinically significant deterioration in independence, 26 (20%) participants reported a clinically significant deterioration in their social relationships, and 34 participants (40%) reporting a clinically significant deterioration in their psychological wellbeing. Nine of the twelve individual items (in AQoL dimension) deteriorated after injury, there was no change in two items (vision and hearing) and an improvement reported in one (communication). The largest changes (> 25% of participants) were reported with sleeping, anxiety worry and depression, and pain. Across the global AQoL dimension, 65 (49%) participants reported a clinically significant deterioration. The severity of injury as measured by the ISS was an independent predictor of the change in AQoL scores (p<0.001).

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