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Abstract
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INTRODUCTION: Injury patterns after falls from a height >∈3 m represent a significant mechanism of multiple trauma and are frequently subjected to forensic autopsy to establish the cause of death.
AIM: The aim of this study was to determine whether there is a relationship between the height of a fall and the resulting injury pattern and to determine whether certain injury patterns can be related back to the height of the fall and the circumstances of death (e.g. suicide, homicide or accidental). Material and methods: The study included 326 cases (median age 40 years, interquartile range IQR 25.3 years) of fatal falls from a height in Berlin from 1988-2004. A retrospective analysis of police investigation files and autopsy reports in this 17-year period was conducted. A floor height of 3 m was assumed.
RESULTS: A total of 206 men (63∈%, median age 38 years, IQR 23.3 years) and 120 women (37∈%, median age 44.5 years, IQR 30.5 years) were included in the study. The analysis showed that suicides predominated (68.7∈%) followed by household accidents (10.4∈%) and accidents at work (8∈%). Homicides were not identified. The median height of falling was from the fifth floor (15 m, IQR 2 m) and suicide victims fell from greater heights significantly more often which resulted in more severe injury patterns. Primary head impact predominated (22.7∈%) and was mostly present in falls from the third floor and higher (first floor 50∈%, second floor 40∈%). The frequency of head injuries decreased between the fifth and eighth floors. The most frequent bony injuries were rib fractures (87.1∈%), pelvic fractures (60.7∈%), skull base fractures (51.5∈%) and skull fractures (50∈%). The most frequently injured chest organ was the lungs (72∈%) and the most frequently injured abdominal organ was the liver (69∈%). Almost all investigated injury patterns were already detected in falls from above the first floor. The number and severity of injuries increased significantly with increasing height of falling, except for injuries of the cervical spine, sternal fractures, fractures of the hands and feet and vascular injuries of the neck. Specific injury patterns attributable to a defined falling height or specific circumstances of death were not detected.
CONCLUSION: Assignment of a defined floor to a specific injury pattern or circumstances of death (e.g. suicide, homicide or accidental) is not possible in individual cases. For future studies, all variables should be collected in a more detailed and standardized way to ensure more comparability. © 2014 Springer-Verlag Berlin Heidelberg.
Language: de |