Impact of falls on early mortality from severe traumatic brain injury

After exclusion criteria were applied, a total of 2162 patients were eligible for analysis. Falls contributed to 21% of all severe TBI, 12% occurring from > 3 meters and 9% from < 3 meters. Two-week mortality ranged from 18% due to injuries other than falls to 31% due to falls from < 3 meters (p =< 0.0001). Mortality after a severe TBI is much greater among older people, reaching 58% for people 65 years and older sustaining a fall from < 3 meters.Among those 65 and older, falls contributed to 61% of all injuries and resulted in especially high mortality among individuals experiencing low falls. Preventive efforts directed toward older people to avoid falls from < 3 meters could have a significant impact on mortality.Traumatic brain injury (TBI) is the leading cause of death among ages 1 to 44 years. Each year in the United States there are 50,000 deaths from TBI and an additional 70,000 to 90,000 individuals are left with permanent neurological disabilities [1]. TBI is the leading cause of death among all trauma-related deaths [2,3].Since 2000, a quality improvement (QI) program exists in New York for tracking the treatment of severe TBI patients (Glasgow Coma Scale [GCS] score < 9) in 24 of the 46 state designated trauma centers. The program, initiated by the Brain Trauma Foundation and funded through the New York State Department of Health Bureau of Emergency Medical Services, is designed to assess and implement adoption of the evidence-based Guidelines for the Management of Severe Traumatic Brain Injury. The Guidelines were formulated and disseminated in 1995 [4] and updated in 2000 [5] and 2006 [6] by the Brain Trauma Foundation in collaboration with the American Association of Neurological Surgeons.Severe TBI results in prolonged hospital stays and is the most common cause of traumatic deaths [7,8]. Most severe TBIs are due to falls or motor vehicle-related incidents [9]. The populations at risk for the causes of injury vary by age and other demographic charact