Abstract
BackgroundApproximately one third of subjects ≥65 year old and half of subjects ≥80 years old sustain a fall injury each year. We aimed to study the outcomes of fall from a height (FFH) among older adults. We hypothesized that in an elderly population, fall-related injury and mortality are the same in both genders.MethodsA retrospective analysis was conducted between January 2012 and December 2016 in patients who sustained fall injury at age of at least 60 years and were admitted into a Level 1 Trauma center. Patients were divided into 3 groups: Gp-I: 60–69, Gp-II: 70–79 and Gp-III: ≥80 years old. Data were analyzed and compared using Chi-square, one-way analysis of variance (ANOVA) and logistic regression analysis tests.ResultsForty-three percent (3665/8528) of adult trauma patients had FFH and 59.5% (2181) were ≥ 60 years old and 52% were women. The risk of fall increased with age with an Odd ratio (OR) 1.52 for age 70–79 and an OR 3.40 for ≥80.Females fell 1.2 times more (age-adjusted OR 1.24; 95% CI 1.05–1.45) and 47% of ≥80 years old suffered FFH. Two-thirds of FFH occurred at a height ≤ 1 m. Injury severity (ISS, NISS and GCS) were worse in Gp-II, lower extremities max Abbreviated Injury score (max AIS) was higher in Gp-III. Overall mortality was 8.7% (Gp-I 3.6% vs. 11.3% in Gp-II and 14% in Gp- III). Males showed higher mortality than females in the entire age groups (Gp-I: 4.6% vs 1%, Gp-II: 12.9% vs 4.2% and Gp-III: 17.3% vs 6.9% respectively). On multivariate analysis, shock index (OR 3.80; 95% CI 1.27–11.33) and male gender (OR 2.70; 95% CI 1.69–4.16) were independent predictors of mortality.ConclusionsFall from a height is more common in older adult female patients, but male patients have worse outcomes. Preventive measures for falls at home still are needed for the older adults of both genders.
Highlights
One third of subjects ≥65 year old and half of subjects ≥80 years old sustain a fall injury each year
It has been estimated that one in four of people in the Western countries will be at geriatric age by the year 2030, and health care costs for fall-related injuries will be a major issue in the geriatric population [10, 11]
The purpose of this study is to find out clinical characteristics, patterns, and outcomes of fall related injuries in older adults patients admitted to a Level I regional trauma center
Summary
One third of subjects ≥65 year old and half of subjects ≥80 years old sustain a fall injury each year. We hypothesized that in an elderly population, fall-related injury and mortality are the same in both genders. Adults age 60 and older are the fastest growing segment of the population in the world. In the USA the number of the older adults is expected to reach 89 million by 2050, while globally from 2025 to 2050, the older population is projected to reach 1.6 billion. 3 million elderly people are treated in the emergency department for fall-related injuries which are always. It has been estimated that one in four of people in the Western countries will be at geriatric age by the year 2030, and health care costs for fall-related injuries will be a major issue in the geriatric population [10, 11]. Older adults trauma patients have distinct patterns of injuries because of their unique physiologic, behavioral, and anatomical characteristics, trauma is expected to dramatically affect the older adults quality of life [15]
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