Citation

Papadopoulos IN, Bonovas S, Kanakaris NK, Nikolopoulos G, Kotsilianou O, Konstantoudakis G, Leukidis C. Injury 2012; 43(9): 1522-1526.

Affiliation

National & Kapodestrian University of Athens, University General Hospital 'Attikon', Fourth Surgery Department, 1 Rimini Street, 12462 Athens, Greece.

Copyright

(Copyright © 2012, Elsevier Publishing)

DOI

10.1016/j.injury.2010.11.056

PMID

21194690

Abstract

INTRODUCTION: The frequency of alcohol and psychoactive drugs in fall-related fatalities and their effect on type, severity of injury and location of death constitute the subjects of this study. METHODS: A retrospective analysis based on autopsy and toxicology compared demographics, location of injury; intention for the injury, height of fall, Abbreviated Injury Scale - 90 (AIS-90), post-mortem Injury Severity Score (ISS), and location of death. RESULTS: Amongst 655 fall-related fatalities screened for alcohol and psychoactive drugs 123 (18.8%) were classified in the positive toxicology group (PTG) and the remaining in the negative toxicology group (NTG). The median ages were 48 (16-94) years for the PTG and 62 (12-96) years for the NTG. The screened represent 31% of the national toll. The median height of fall was 7m and the median blood alcohol concentration was 53 (1.5-630)mg/dl. Males were more likely to be included in the PTG than females (21.6 versus 13.6%; p=0.014) as were the aged between 11 and 60 years. The odds of severe (AIS≥3) head, thoracic, abdominal, extremity, and spine injuries were not influenced by toxicology status. Fatalities of the PTG were as likely to have severe trauma (ISS≥16) as were fatalities of the NTG (93.5 versus 90.8%; p=0.34). There was no significant difference of ISS between PTG (median ISS 43, range: 6-75) and NTG (median ISS 35, range: 3-75). Nevertheless, 76.4% of the subjects of the PTG died during the pre-hospital stage of care compared to 60.5% of the subjects of the NTG, which was highly significant (or=2.80, p=0.001) after controlling for confounders as age, gender, intention for injury, height of fall, and ISS. CONCLUSIONS: In fall related trauma, alcohol and psychoactive drugs increased the risk of death during the pre-hospital stage by 2.80 times. This is strong evidence that specific protocols for their early management should be instituted.

Language: en