Frontiers in Neurology (Jul 2025)

Comparison of traumatic brain injury resulting from stair-related falls to falls from standing height—a neurotrauma center cohort

  • Cathrine Tverdal,
  • Andrew Reiner,
  • Eirik Helseth,
  • Eirik Helseth,
  • Torgeir Hellstrøm,
  • Unn Sollid Manskow,
  • Unn Sollid Manskow,
  • Mads Aarhus,
  • Mads Aarhus,
  • Karoline Skogen,
  • Pål Rønning,
  • Dag Ferner Netteland,
  • Dag Ferner Netteland

DOI
https://doi.org/10.3389/fneur.2025.1599229
Journal volume & issue
Vol. 16

Abstract

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BackgroundFalls are the leading cause of traumatic brain injury (TBI) in high-income countries, and globally, the incidence of fall-related injuries is projected to rise. In this study, we compare TBI resulting from stair-related falls (SRFs) to falls from standing height (FSH), analyzing their epidemiology and outcomes.MethodsIn a single-center, registry-based cohort study using the Oslo TBI Registry-Neurosurgery (OTBIR-N), we identified adults (≥18 years) admitted to Oslo University Hospital with TBI from either SRFs or FSH between 2015 and 2022. Epidemiology and outcome measures were compared between the two groups, and a multivariate logistic regression model was used to evaluate the adjusted effect of the fall mechanisms on dichotomized functional outcome (Glasgow outcome score (GOS) 1–3 vs. GOS 4–5).ResultsA total of 1,432 patients with a median age of 71 years were included. SRFs represented 25%, while FSH represented 52% of all fall-related TBIs. SRF patients were generally younger and healthier, with a higher frequency of moderate to severe TBI than FSH patients (53% vs. 31%; p < 0.001). SRFs also occurred more often during evenings and nights, on weekends, and were more often related to alcohol influence (58% vs. 22%; p < 0.001). Both fall types resulted in unfavorable functional outcomes (GOS 1–3) for a substantial proportion of patients (37% in SRFs and 42% in FSH; p = 0.066). When adjusting for covariates in the multivariable logistic regression model, there was a tendency of SRFs being associated with unfavorable outcomes compared to FSH, but the effect was not statistically significant (OR 1.43, 95%CI 0.97–2.12; p = 0.073).ConclusionSRFs represented a considerable proportion of fall-related TBIs and were associated with poor outcomes in a substantial proportion of patients. Targeted public awareness campaigns addressing the risks associated with staircases, especially when combined with alcohol influence, seem warranted to prevent such injuries.

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