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A comparative autopsy study of the injury distribution and severity between suicidal and accidental high falls

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Abstract

Falls are the second cause of accidental deaths worldwide. Falls from height are also a common method of suicide. The aim of this study is to compare the characteristics of the victims, the circumstances of the fall and the severity and distribution of the injuries reported in an autopsy case series of falls from height. This study is a retrospective analysis of consecutive autopsy cases of suicidal and accidental falls from height which were investigated in the Department of Forensic Medicine and Toxicology of the National and Kapodistrian University of Athens during the period 2011–2019. The recorded variables included demographic data of the victim, height of fall, length of hospital stay, toxicological results, the existence and location of injuries and Injury Severity Score (ISS). Victims of suicidal falls were younger (55.53 vs. 62.98, p = 0.001), they fell from higher heights (12.35 vs. 5.18 m, p < 0.001), and they sustained more severe injuries compared with victims of accidental falls (ISS 51.01 vs. 40.88, p < 0.001). Injuries in the thorax, abdomen, pelvis, upper and lower extremities were more frequently observed after a suicidal fall (93.6% vs. 67.3%, 72.1% vs. 21.4%, 72.1% vs. 27.6%, 42.9% vs. 15.3%, 45.7% vs. 13.3%, respectively-p < 0.001), probably due to the higher height of fall. Our study outlines the differences in the profile of the victims and in the severity of injuries caused by falls from height depending on the intention of the victim to fall. However, a distinctive injury pattern in victims of suicidal falls was not demonstrated.

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All data generated or analyzed during this study are included in this published article or are available from the corresponding author on reasonable request.

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Authors and Affiliations

  1. Department of Forensic Medicine and Toxicology, National and Kapodistrian University of Athens, Athens, Greece

    Maria Tsellou, Artemis Dona, Nikolaos Goutas, Chara Spiliopoulou & Stavroula A. Papadodima

  2. 2nd Department of Psychiatry, Attikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece

    Anastasia Antoniou

  3. Nemea Medical Center, Nemea, Corinthia, Greece

    Efstathios Skliros

  4. Henry Dunant Hospital Center, Athens, Greece

    Iordanis N. Papadopoulos

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  1. Maria Tsellou
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  8. Stavroula A. Papadodima
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Contributions

MT was responsible for the collection and interpretation of data, and she participated in drafting and writing the article. AD performed the evaluation of the toxicological results and she participated in drafting and writing the article. AA and ES performed the statistical analysis and evaluated the results. IP participated in the conception of the study, and he participated in drafting and writing the article. NG, CS and SP participated in the conception and design of the study and revised the article for critically important intellectual content. NG, CS and SP had also performed the autopsies. All the authors approved the final version to be published.

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Correspondence to Stavroula A. Papadodima.

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The Department of Forensic Medicine and Toxicology of the National and Kapodistrian University of Athens is authorized to perform the forensic investigation of more than one third of violent and sudden deaths occurring in Attica (Athens metropolitan area). The study was approved by the Ethics Committee of the National and Kapodistrian University of Athens.

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Tsellou, M., Dona, A., Antoniou, A. et al. A comparative autopsy study of the injury distribution and severity between suicidal and accidental high falls. Forensic Sci Med Pathol 18, 407–414 (2022). https://doi.org/10.1007/s12024-022-00496-z

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