Analysis of fall from height cases due to electrical injury: evaluation by comparing with fall from height and only electrical injury cases

Year 2023, Volume: 50 Issue: 4 - Cilt 50, Sayı 4, 497 - 506, 29.12.2023

Mustafa İçer

https://doi.org/10.5798/dicletip.1411524

Abstract

Objective: Trauma is the leading cause of deaths worldwide. Electrical injury causes many damage to the body according to the elektrical load, considerably mortality.
Falls from height are one of the most common causes of trauma in the world, it is a condition with high morbidity and mortality.
Falls from height due to electrical injury that caused by mechanisms both electrical injury and falling from a height are complex injuries .
Although cases of falling from height due to electrical injury have been reported in the literature, there are no studies examining them.
The aim of this study is to examine cases of falls from height due to electrical injury, its clinical features were compared to only electrical injury cases and only falls from height.
Methods: This is a retrospective cross-sectional study. Cases admitted to the emergency department of Dicle University Hospital between January 2015 and December 2021 were examined. In this study, 75 cases who fell from a height due to electrical injury, 75 cases who had only electrical injury, and 75 cases who fell only from a height were received.
Trauma cases included in the study were examined age, gender, ground of fall, fall height, workplace accident and suicide status, electrical voltage, burn and trauma scores, laboratory findings, mortality.
Results: Among the 75 cases falling from height due to electrical injury, 69 (92%) survived, 6 (8%) died. The median age was 24 (IQR: 17-37) years old. Of the cases, 70 (93.30%) were male, 53 (70.70%) were high voltage, 35 (46.70%) were workplace accidents. Among the variables examined, lactic dehydrogenase (LDH), creatinine kinase (CK), creatinine kinase myocardial band (CK-MB), total body burn surface area (TBSA%), Glasgow Coma Scale (GCS), Abbreviated Injury Scale (AIS) for burns were the factors affecting mortality( p<0.05). Comparison of cases who fell from a height due to electric injury and cases of only electric injury TBSA%, AIS for burns, Abbreviated Burn Severity Index (ABSI), Injury Severity Score (ISS), complications, high voltage, length of stay (LOS) were higher in patients who fell from height due to electric injury, with a significant difference (p<0.001). Comparison of cases of falling from a height due to electric injury and cases of only falling from height age, male gender, workplace accident rate were higher in patients who fell from height due to electric injury, with a significant difference (p<0.001).
Conclusion: Falls from height due to electrical injury are major traumas that affect young adult men and have high mortality and complication rates, caused by high-voltage electrical injury. This trauma mechanism shows differences from only electric injury and only falls from height injuries.

Keywords

Fall from height due to electrical injury, fall from height, electrical injury, mortality, workplace accident

References

• 1.Tomas C, Kallies K, Cronn S, Kostelac C, deRoon-Cassini T, Cassidy L. Mechanisms of traumatic injuryby demographic characteristics: an 8-year review oftemporal trends from the National Trauma DataBank. Inj Prev 2023;0:1-8.https://doi.org/10.1136/ip-2022-044817
• 2.Yiğit E, Şener Bahçe Z. Evaluation of theEpidemiological Characteristics of the PatientsAdmitted to Our Clinic as a Result of Electric Shock.Journal of Burn Care & Research 2022;43:121-25.https://doi.org/10.1093/jbcr/irab044
• 3.Nau C, Leiblein M, Verboket R.D, Hörauf J.A, SturmR, Marzi I. Falls from Great Heights: Risk to SustainSevere Thoracic and Pelvic Injuries Increases withHeight of the Fall. J. Clin. Med 2021;10 (2307);1-9.https://doi.org/10.3390/jcm10112307
• 4.Türkoğlu A, Sehlikoğlu K, Tokdemir M. A study offatal falls from height. Journal of Forensic and LegalMedicine 2019;61:17-21.https://doi.org/10.1016/j.jflm.2018.10.008
• 5.Akkoca M, Tokgöz S, Yılmaz KB, et al. Mortalitydeterminers for fall from height cases. TurkishJournal of Trauma & Emergency Surgery2018;24:445-49.https://doi.org/10.5505/tjtes.2018.50724
• 6.Goren S, Subasi M, Tirasci Y, Gurkan F. Fatal fallsfrom heights in and around Diyarbakır, Turkey.Forensic Sci Int 2003;137:37-40.https://doi.org/10.1016/S0379-0738(03)00285-8
• 7.Rey-Merchán MC, Gómez-de-Gabriel JM, López-Arquillos A, Choi SD. Analysis of Falls from HeightVariables in Occupational Accidents. Int. J. Environ.Res. Public Health 2021; 18(13417):1-13.https://doi.org/10.3390/ijerph182413417
• 8. Cancio LC, Jimenez-Reyna JF, Barillo DJ, Walker SC,McManus AT, Vaughan GM. One hundred ninety-fivecases of high-voltage electric injury. J Burn CareRehabil 2005;26:331-40.https://doi.org/10.1097/01.BCR.0000169893.25351.A9
• 9.Kaya H, Gökdemir MT, Söğüt Ö, Sayhan MB. TheFactors Affecting Mortality In Adults Due To HighVoltage Electrical Injuries. Düzce Tıp Dergisi2013;15: 22-26.
• 10. Habouchi S, Bouamra A, Bezzaoucha A, Joucdar S.Estimation of survival rate in electrical injuries,experience in Algerian Burn Centers. Burns Open2020;4: 141- 45.https://doi.org/10.1016/j.burnso.2020.07.001
• 11.Thompson L, Hill M, Shaw G. Defining majortrauma: a literature review. Br Paramed J.2019;4:22-30.https://doi.org/10.29045/14784726.2019.06.4.1.22
• 12.Ding H, Huang M, Li D, Lin Y, Qian W.Epidemiology of electrical burns: a 10-yearretrospective analysis of 376 cases at a burn centrein South China. Journal of International MedicalResearch. 2019; 48: 1-10.https://doi.org/10.1177/0300060519891325
• 13.Uzun İ, Bombacı E, Çevik B. Determinant ofMortality in Patients with Electrical Burn Injury.Boğaziçi Tıp Dergisi; 2018; 5:1-6.
• 14.Alizo G, Sciarretta JD, Gibson S, et al. Fall fromheights: does height really matter? Eur J TraumaEmerg Surg (2018) 44:411-16.https://doi.org/10.1007/s00068-017-0799-1
• 15.Al B,Yıldırım C, Çoban S. Falls from heights in andaround the city of Batman. Turkish Journal ofTrauma & Emergency Surgery 2009;15:141-47.
• 16.Shih JG, Shahrokhi S, Jeschke MG. Review of adult electrical burn injury outcomes worldwide: ananalysis of low-voltage vs high-voltage electricalinjury. J Burn Care Res 2017;38:e293-8.https://doi.org/10.1097/BCR.0000000000000373
• 17.Ozdel S, Kargın Çakıcı E, Sayli TR. Pediatricelectrical injury in Turkey: Five year retrospectivehospital-based study. Pediatrics International 2019;61;1155-58. https://doi.org/10.1111/ped.14008
• 18.Schweizer R, Pedrazzi N, Klein HJ, et al. RiskFactors for Mortality and Prolonged Hospitalizationin Electric Burn Injuries. Journal of Burn Care &Research 2021;42:505-12.https://doi.org/10.1093/jbcr/iraa192
• 19.Gurbuz K, Demir M. Patterns and Outcomes ofHigh-Voltage vs Low-Voltage Pediatric ElectricalInjuries: An 8-Year Retrospective Analysis of aTertiary-Level Burn Center, Journal of Burn Care &Research 2022;43:704-9.https://doi.org/10.1093/jbcr/irab178
• 20.Saracoglu A, Kuzucuoglu T, Yakupoglu S, et al.Prognostic factors in electrical burns: a review of101 patients. Burns. 2014;40:702-707.https://doi.org/10.1016/j.burns.2013.08.023
• 21.Lapostolle F, Gere C, Borron SW, et al. Prognosticfactors in victims of falls from height. Crit Care Med2005;33:1239-42.https://doi.org/10.1097/01.CCM.0000164564.11989.C3
• 22. Liu CC, Wang CY, Shih HC, et al. Prognostic factorsfor mortality following falls from height. Injury, Int.J.Care Injured 2009;40:595-97. https://doi.org/10.1016/j.injury.2008.11.014
• 23.Yan GR, Li M, Wu Y. A clinical analisis of 836 cases with elektric injury. Ann N Y Acad Sci.1999;888:88-95.https://doi.org/10.1111/j.1749-6632.1999.tb07944.x
• 24.Goodacre S, Than M, Goyder EC, et al. Can thedistance fallen predict serious injury after a fall from a height? J Trauma 1999;46:1055-8.https://doi.org/10.1097/00005373-199906000-00014