Abstract
Introduction Major trauma centres are increasingly managing a significant injury burden in older patients, with falling downstairs being a prevalent mechanism of injury. Literature evaluating the impact of falls on stairs upon UK trauma networks is limited. Gaining a greater understanding of this may allow for more effective planning of services and improvements in training and education. This study evaluates the impact of falls downstairs on a UK major trauma centre. Methods A single centre retrospective service evaluation of local major trauma data over a 3-year period from 01/01/2017 to 31/12/2019. Included were patients who activated a trauma call whose mechanism of injury recorded at the time of admission was a fall downstairs. We excluded patients less than 16 years of age. Results There were 4480 major trauma patients who presented in the study period and of these, 860 (19.2%) sustained injuries following a fall downstairs. The most common age group presenting was 70–79 years; younger patients (<60 years) made up 43.3% with the majority (56.7%) being older. All but one patient were managed by a consultant-led trauma team, 6.4% of patients were admitted to critical care and 1% received an urgent operation. The overall mortality rate was 8.5%. Older patients made up 85% of those who died and had nearly four times longer average length of stay than younger patients (9.69 v 2.49 days). Conclusion Falls downstairs place a significant burden on the major trauma centre. There is a stark contrast in the use of hospital resources and outcomes between older and younger patients.
Highlights
Major trauma centres are increasingly managing a significant injury burden in older patients, with falling downstairs being a prevalent mechanism of injury
This study evaluates the impact of falls downstairs on a UK major trauma centre
Regardless of the reasoning, what can be deduced from the results found here is that as a cohort, older patients have a greater impact on hospital resources
Summary
Major trauma centres are increasingly managing a significant injury burden in older patients, with falling downstairs being a prevalent mechanism of injury. Major trauma networks are managing a significant injury burden in older patients, with falls being the most common causative mechanism and falling downstairs in itself being a prevalent and significant mechanism of injury.[1,2,3] A study from the Netherlands of 5880 patients who presented to hospital following a fall found that over half of those diagnosed with a traumatic brain injury had fallen up or down a flight of stairs.[3] Friedland et al in the UK confirmed this finding, with stairway falls being a leading cause of fall-related traumatic brain injury[4] and Chatha et al concluded that older patients are more likely to incur serious injury and younger patients are more likely to be intoxicated.[2]. This study evaluates the impact of falls downstairs on a UK major trauma centre
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