Injury patterns and clinical outcomes following falls from a medium-height bridge: A retrospective study

Abstract

Background: falls from height are associated with significant traumatic injuries and poor outcomes. Improving our understanding of patterns associated with this patient group enables clinicians to improve their patient management in the prehospital and hospital environment.

Objectives: to describe the injury patterns and clinical outcomes of patients presenting to the Emergency Department at University Hospitals Southampton after falling from the Itchen Bridge, Southampton.

Methods: we conducted a retrospective cohort study of thirty patients who attended University Hospital Southampton following a fall from the Itchen Bridge between 2011 and 2023. Twenty-six patients who fell into water from heights of approximately 20-30m were included in the primary analysis. Clinical data were then extracted from medical records.

Results: hypothermia was the most common presentation (n = 23), followed by pneumothoraces (n = 14), rib fractures (n = 10), thoracic vertebral fractures (n = 9) and lung contusions (n = 8). Lower water temperatures at the time of the incident (p = 0.008) and lower patient body temperatures on arrival to hospital (p = 0.002) were significantly associated with increased 30-day mortality.

Conclusion: falls from heights of 20-30 m into water frequently results in hypothermia and intrathoracic injuries. Prehospital clinicians attending falls into water from similar heights should recognise the importance of early rewarming to treat hypothermia and be suspicious of intrathoracic injuries.

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