Drugs in fall versus non-fall accidents with major trauma – A population-based clinical and medico-legal autopsy study
Acosta, S. LU
; Andersson, L.
; Bagher, A.
LU
and Wingren, C. J.
LU
(2019)
In Forensic Science International
296.
p.80-84
- Abstract
Background: The main aim of the present population-based study was to compare drugs in fall versus non-fall accidents causing major trauma, including both clinical and medico-legal autopsy data. Methods: All individuals with accidents resulting in major trauma, a new injury severity score (NISS) > 15 or lethal outcome was identified at hospital and/or the Department of Forensic Medicine between 2011 and 2013. Modified Downton Fall Risk Index ranged from 0 to 7, and was based on specific pharmaceuticals (max 5 points), previous fall (1 point) and cognitive impairment (1 point). Results: One hundred and four individuals with major traumatic accidents were identified, 38 (36.5%) died. The median modified Downton Fall Risk Index was 2... (More)
Background: The main aim of the present population-based study was to compare drugs in fall versus non-fall accidents causing major trauma, including both clinical and medico-legal autopsy data. Methods: All individuals with accidents resulting in major trauma, a new injury severity score (NISS) > 15 or lethal outcome was identified at hospital and/or the Department of Forensic Medicine between 2011 and 2013. Modified Downton Fall Risk Index ranged from 0 to 7, and was based on specific pharmaceuticals (max 5 points), previous fall (1 point) and cognitive impairment (1 point). Results: One hundred and four individuals with major traumatic accidents were identified, 38 (36.5%) died. The median modified Downton Fall Risk Index was 2 for fall accidents and 0 for non-fall accidents (p < 0.001). Modified Downton Fall Risk Index was an age-independent factor associated with fall accident (p < 0.001). The medico-legal autopsy rate for in-hospital patients was 50% (6/12) for fatal fall accidents in comparison with 92.3% (12/13) for fatal non-fall accidents (p = 0.03). In individuals undergoing medico-legal autopsy, the proportion of individuals with any detected drug was 77% in fall accidents compared to 39% in non-fall accidents (p = 0.036). The presence of sedatives (p = 0.002) and bensodiazepines (p = 0.023) were higher for fall accidents compared to non-fall accidents. Conclusion: This population-based study on accidents with major trauma showed that drugs had high impact on fall accidents with major trauma. It seems warranted from a public health perspective to study if implementation of medication review guidelines at hospital managing polypharmacy issues may prevent fall accident recidivism.
(Less)
- author
- Acosta, S.
LU
; Andersson, L.
; Bagher, A.
LU
and Wingren, C. J.
LU
- organization
- publishing date
- 2019
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Fall accident, Forensic toxicology, Major trauma, Medico-legal autopsy, New injury severity score
- in
- Forensic Science International
- volume
- 296
- pages
- 5 pages
- publisher
- Elsevier
- external identifiers
-
- scopus:85060702189
- pmid:30710812
- ISSN
- 0379-0738
- DOI
- 10.1016/j.forsciint.2019.01.012
- language
- English
- LU publication?
- yes
- id
- daf75e72-2ce4-446f-8648-e59d5499ce94
- date added to LUP
- 2019-02-04 14:23:13
- date last changed
- 2024-04-15 22:40:30
@article{daf75e72-2ce4-446f-8648-e59d5499ce94,
abstract = {{<p>Background: The main aim of the present population-based study was to compare drugs in fall versus non-fall accidents causing major trauma, including both clinical and medico-legal autopsy data. Methods: All individuals with accidents resulting in major trauma, a new injury severity score (NISS) > 15 or lethal outcome was identified at hospital and/or the Department of Forensic Medicine between 2011 and 2013. Modified Downton Fall Risk Index ranged from 0 to 7, and was based on specific pharmaceuticals (max 5 points), previous fall (1 point) and cognitive impairment (1 point). Results: One hundred and four individuals with major traumatic accidents were identified, 38 (36.5%) died. The median modified Downton Fall Risk Index was 2 for fall accidents and 0 for non-fall accidents (p < 0.001). Modified Downton Fall Risk Index was an age-independent factor associated with fall accident (p < 0.001). The medico-legal autopsy rate for in-hospital patients was 50% (6/12) for fatal fall accidents in comparison with 92.3% (12/13) for fatal non-fall accidents (p = 0.03). In individuals undergoing medico-legal autopsy, the proportion of individuals with any detected drug was 77% in fall accidents compared to 39% in non-fall accidents (p = 0.036). The presence of sedatives (p = 0.002) and bensodiazepines (p = 0.023) were higher for fall accidents compared to non-fall accidents. Conclusion: This population-based study on accidents with major trauma showed that drugs had high impact on fall accidents with major trauma. It seems warranted from a public health perspective to study if implementation of medication review guidelines at hospital managing polypharmacy issues may prevent fall accident recidivism.</p>}},
author = {{Acosta, S. and Andersson, L. and Bagher, A. and Wingren, C. J.}},
issn = {{0379-0738}},
keywords = {{Fall accident; Forensic toxicology; Major trauma; Medico-legal autopsy; New injury severity score}},
language = {{eng}},
pages = {{80--84}},
publisher = {{Elsevier}},
series = {{Forensic Science International}},
title = {{Drugs in fall versus non-fall accidents with major trauma – A population-based clinical and medico-legal autopsy study}},
url = {{http://dx.doi.org/10.1016/j.forsciint.2019.01.012}},
doi = {{10.1016/j.forsciint.2019.01.012}},
volume = {{296}},
year = {{2019}},
}