Fall from grace: Balcony-related trauma

The word balcony is derived from the Italian word balcone from the early 1600s and is defined as a platform built out from the wall.* The earliest balconies first appeared more than 2,000 years ago in ancient Greece, fulfilling primarily functional purposes, such as increasing air circulation in arid climates or allowing infiltration of natural light to the interior of the building. Over the years, balconies have taken on significant roles in literature, theater, film, and daily life—from the famous love scene in Romeo and Juliet, to Eva Perón addressing her country people in Evita, to the Pope speaking to the masses in St. Peter’s Square, Vatican City.

Today, the practical applications of balconies are related more to function. Depending on the size of one’s residence, a balcony may enhance the useable square footage to allow for grilling or dining alfresco. Depending on balcony size, it may also allow for the expansion of a party or celebration. The news and social media remind us of children, teenagers, and young adults who have fallen from balconies around the world, suffering serious or fatal injuries.

Frequency

To examine the occurrence of injuries in patients younger than 21 years old resulting from falling off a balcony, the National Trauma Data Bank® (NTDB) research admission year 2017, medical records were searched using age and the International Classification of Diseases, Tenth Revision Clinical Modification codes. Specifically searched were records of individuals younger than age 21 that contained E code W13.0XXA (fall from, out of, or through balcony, initial encounter). A total of 330 records were found, 259 of which contained a discharge status, including 235 patients discharged to home, 18 to acute care/rehab, two sent with law enforcement, and two sent to skilled nursing facilities; two died (see Figure 1). Of these patients, 64 percent were male, on average 10.8 years of age, had an average hospital length of stay of 3.7 days, an intensive care unit length of stay of 3.9 days, an average injury severity score of 9.9, and were on the ventilator for an average of 3.6 days. Of those tested for alcohol, 40 percent (50 out of 126) tested positive.

Figure 1. Hospital Discharge Status

Figure 1. Hospital Discharge Status

Tragic stories abound of underage youth who have consumed alcohol and have fallen off balconies. While underage drinking alone would result in a fall from grace with their parents, a far more devastating situation may result when engaging in this behavior on a balcony.

Throughout the year, we highlight these data through brief reports that are published monthly in the Bulletin. The NTDB Annual Report can be found on the American College of Surgeons website as a PDF file. In addition, information is available on our website about how to obtain NTDB data for more detailed study. If you are interested in submitting your trauma center’s data, contact Melanie L. Neal, Manager, NTDB, at mneal@facs.org.

Acknowledgment

Statistical support for this column was provided by Ryan Murphy, Data Analyst, NTDB.


*English Oxford Living Dictionaries. Balcony definition. Available at: https://en.oxforddictionaries.com/definition/balcony. Accessed May 21, 2019.

Balconette. Balconies through the ages. Available at: www.balconette.co.uk/juliet-balcony/articles/balconies-through-the-ages. Accessed May 21, 2019.

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