Ground-Level Fall vs. Other Mechanisms of Injury in Patients With a Shock Index of Greater Than One at a Rural Level 1 Trauma Center

Ground-level falls (GLFs) often are viewed as minor injuries but can pose significant risks for patients with a shock index (SI) greater than one. This retrospective study is aimed at comparing outcomes of GLF patients with a high SI to those who sustained trauma via other mechanisms who also have a SI>1 to provide insight for improved trauma care. Conducted at Johnson City Medical Center in Johnson City, Tennessee, from September 1, 2021, to January 1, 2024, the study analyzed data from a trauma registry and EpicCare Link (Epic Systems Corporation, Verona, USA), focusing on demographics, injury details, and clinical outcomes. 387 patients met the inclusion criteria. 16.5% (n=64) of patients comprised the GLF population, were older (mean of 65.6 vs 43.6 years, p<0.001), predominantly female (p<0.001), and more likely referred from other facilities (p<0.001). They had lower injury severity scores (ISS) (p=0.002), lower emergency medical service (EMS) shock index scores (p=0.012), and were less likely to need surgery (p=0.007). All patients had an SI>1. Despite these differences, mortality rates were similar to those of other trauma patients, emphasizing the critical nature of GLFs despite their seemingly benign mechanism.