International Journal of Biomedicine (Jun 2015)
Objective Assessment of the Severity of Patients Suffering from Fall from Height with Combined Injuries of the Abdominal Parenchymal Organs
Abstract
In recent years, fall from a height (FFH) has been a relatively frequent cause of injury and death in the urban environment. The purpose of this study was to optimize the risk stratification of FFH victims with combined injuries of the abdominal organs by using Injury Severity Score (ISS) scale. The study included 111 patients (aged between 15 and 80 years) injured by FFH. All the falls were accidental and occurred mainly among males (82%). The height of the fall ranged from 2 to 5 meters. Combined injuries were found in 98 patients and isolated injuries in 13 patients. The combination of the 6 injured body regions was identified in 5 patients, 5 regions in 17, 4 in 35, 3 in 23, and 2 in 18. The abdomen trauma was most commonly associated with the following injured body regions: head and neck-chest-extremities and pelvis (13.3%), head and neck-chest-extremities (12.2%), and head and neck-chest-pelvis (9.2%). Among the combined injuries of the abdomen, ruptures of parenchymal organs (liver, spleen and kidneys) were predominant. To assess the severity of the injury, the ISS scale was applied. The injuries of abdominal parenchymal organs were evaluated according to the AAST (American Association for the Surgery of Trauma) classification. Comparative analysis of the assessment of the severity of a patient's condition according to the traditional scale and the ISS scale showed that the ISS scale promotes the active and timely detection of the extremely severe and terminal condition in patients with injuries due to FFH with combined trauma of the abdominal organs. Objective assessment of the severity of trauma and the dominant injury region allows determining the optimal treatment algorithm and predicting the outcome of the injury.
