Unit:
Faculty of MedicineLibrary of the School of Health Sciences
Dissertation committee:
Χάιδω Σπηλιοπούλου, Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Σωτήριος Αθανασέλης, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Σταυρούλα Παπαδόδημα, Αναπληρώτρια Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Κωνσταντίνος Μωραΐτης, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Αρτεμησία Ντονά, Αναπληρώτρια Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Δημήτριος Βλαχοδημητρόπουλος, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Νικόλαος Γούτας, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Original Title:
Ιατροδικαστική διερεύνηση των περιπτώσεων θανάτων λόγω πτώσης από ύψος
Translated title:
Forensic investigation of deaths due to fall from height
Summary:
Falls have emerged as an important problem worldwide with a great socioeconomic cost. Their ever-increasing frequency and the severity of the injuries they cause make it imperative to thoroughly study their causes, the mechanisms involved and the conditions that favor them.
The aim of this study is to investigate the profile of the victims, the circumstances of the fall and the characteristics of the injuries reported.
The subject of this study are the two hundred and twenty-five autopsy cases which occurred in regions of Attica (Northeast, East and South suburbs) and Evia and were assigned to the Laboratory of Forensic Medicine and Toxicology of National and Kapodistrian University of Athens during the years 2011-2015. For these cases, epidemiological data of the victims, variables regarding the conditions under which the fall took place, as well as the type and the location of the injuries were recorded and statistically processed.
Among these 225 cases, 148 fatal falls from one level to another, 43 fatal ground-level falls and 34 fatal staircase falls were recorded. Falls from height included 57 accidental (38.5%), 86 suicidal (58.1%) falls and 5 cases (3.4%) with unknown cause. All ground-level fall cases were accidents, while 33 fatal falls from stairs (97.1%) were accidents and in only 1 case (2.9%) the cause was unknown.
The victims consisted of 153 men and 72 women. In all types of falls, men outnumbered women. The victims’ ages ranged from 21 to 97 years and more than half of the victims (121/225) were elderly (> 65 years).
As for the medical history of the victims, only 25.3% did not have any known health problem, while for 8.4% the medical history was unknown. The 52.4% of the victims had a positive psychiatric history, the existence of which was associated with suicidal falls from height.
The majority of incidents (59.6%) took place in the victim’s home or in the surrounding area. Data on the height of falls were known in 127 of the 148 cases of falling from height. The fall height ranged from 1.5 meters to 50 meters. The falls from a relatively low height, up to 3 meters, were 32 (25,2%) and the remaining falls were from over 3 meters. Low fall heights up to 3 meters were associated with accidental falls, while suicidal falls occurred from higher heights, with this relationship being statistically significant.
Toxicological blood analysis was performed in 163 of the recorded cases. In the remaining 62 cases, no toxicological analysis was performed due to the long hospitalization of the victims after the fall. Eighty victims (49.1%) were negative for the substances tested, while in 30 (18.4%) some blood alcohol concentration was found.
The anatomical regions that most often showed severe injuries were the head and the chest, while the lowest incidence of serious injuries was recorded in the cervical spine and lower extremities.
Severe head injuries were much more frequent in accidental (76.7%) than in suicidal (65.1%) falls although there is no statistically significant relationship. On the other hand, chest injuries were recorded in significantly more suicidal falls (80 cases-93%) compared to accidental falls (49 cases-36.8%). It is also characteristic that there was a very low frequency of upper limb injuries recorded in accidental falls (21.8%) compared to suicidal falls (72.7%) (statistically significant relationship). Correspondingly, the injuries of the lower extremities showed higher rates of intentional falls-suicides (73.5%) compared to unintentional falls-accidents (14.3%).
In general, the results of the present study are in agreement with some findings of similar international studies, while differing from others. Therefore, it should be emphasized that there is a need to continue the study of falls in Greece in order to better understand the special characteristics of the victims and the conditions that may affect both their cause and fatal outcome.
Main subject category:
Health Sciences
Keywords:
Falls from height, Fatal falls, Staircase falls, Suicides, Accidents, Blunt traumatic injuries
Number of references:
428
