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Journal of the Korean Society of Traumatology 2005;18(2):101-106.
The Height of Fall as a Predictor of Fatality of Fall
Joo Hyun Suh, M.D., Eun Kyung Eo, M.D., Koo Young Jung, M.D.
Department of Emergency Medicine, College of Medicine, Ewha Womans University
추락 후 사망 예측인자로서의 추락 높이
서주현·어은경·정구영
이화여자대학교 의과대학 응급의학교실
Abstract
Purpose
The number of the deceased from free-fall is increasing nowadays. Free-fall comes to a great social problem in that even the survivor will be suffering for cord injury or brain injury, and so on. We analyzed the cases of free-fall patients to find out whether the injury severity is mainly correlated with the height of fall. Methods: We retrospectively investigated the characteristics of patients, who fall from the height above 2m from January 2000 to August 2004. We excluded the patients who transferred to other hospital, transferred from other hospital, and not known the height of fall. 145 patients were evaluated. Variables included in data analysis were age, height of fall, injury severity score (ISS), the being of barrier, and the survival or not. To find out the correlation between height of fall and death, we used receive operating characteristics (ROC) curve
analysis. Results: The mean age of patients was 36.5±19.4 years old. 110 were male and 35 were female. Mean height of fall was 11.1±8.5m. 51 patients (35.2%) were died and 30 patients of them (58.9%) got emergency room on dead body. The mean height of fall is 8.9±5.8m for 94 survivors and 15.2±11.0m for the 51 deceased (p<0.001). The area under the ROC curve was 0.646, which means the height of fall was not adequate factor for predicting for death. At 13.5m, as cut?off value, sensitivity is 52.9%, specificity is 86.2%, positive predictive value is 67.5% and negative predictive value is 77.1%. There were statistical differences in mortality rate and ISS between ‘below 13.5m group’and ‘above 13.5m group’, but there was not statistical difference in head and neck AIS. Conclusion: The height of fall is not adequate factor for prediction of death. So other factors like intoxication or not, the being of barrier or protection device need to be evaluated for predicting of free-fall patient’s death.
Key Words: Free-fall; Injury severity score; Height; Mortality
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