Abstract
ABSTRACTOBJECTIVETo estimate the trends of fall-related hospitalization, mortality, and lethality among older adults in Brazil and regions.METHODSThis is a descriptive study based on data from the Hospital Information System of the Brazilian Unified Health System. We included records of every older adult, aged 60 years or older, hospitalized for accidental fall from January, 1998 to November, 2015 in all Brazilian regions. We selected the codes E885, E886, E880, E884, E884 from the International Classification of Diseases, 9th revision, and W01, W03, W10, W17, W18 from the 10th revision, and calculated fall-related hospitalization and mortality rates per 100,000 inhabitants, as well as lethality. To estimate trends, we applied the Prais-Winsten regression for time series analysis.RESULTSDuring the period, 1,192,829 fall-related hospitalizations occurred, among which 54,673 had a fatal outcome; lethality was 4.5%. Hospitalization rates showed upward trends, with seasonality, in Brazil (11%), and in the Northeast (44%), Midwest (13%), and South regions (14%). The North showed a decreasing hospitalization rate (48%), and the Southeast a stationary one (3%).CONCLUSIONSIn Brazil, fall-related hospitalizations, mortality, and lethality among older adults showed an upward trend from 1998 to 2015, with seasonal peaks in the second and third quarters. Considering we are in plain demographic transition, to improve hospital healthcare and encourage falls prevention programs among older adults is essential.
Highlights
Accidental Falls are unexpected events in which people come to rest on the ground, floor, or lower levels[1,2,3]
Accidental falls are more common at an old age and their sequelae may decrease functional independence and increase the risk of early death[4]; old age associated with natural depletion of physiological systems and functionality, increased morbidity, and early institutionalization turns accidental falls into a public health matter[4]
Considering that, this study aimed to estimate the trend and seasonality of fall-related hospitalization, mortality, and lethality rates among older adults in Brazil and regions. For this time series study, we collected data from the HIS/SUS (Hospital Information System of the Brazilian Unified Health System) available in the Department of Informatics of the Brazilian Unified Health System (DATASUS) – a public database managed by the Ministry of Health, whose data use does not require ethical approval
Summary
Accidental Falls are unexpected events in which people come to rest on the ground, floor, or lower levels[1,2,3]. They affect 30% of older adults over 60 years, and 40 to 50% of seniors aged from 80 to 85 years. Among these groups (especially the long-lived), falls are the leading causes of injuries, fatal or not[3,4,5]. Fall-related hospitalizations imply survival rates: only about 50% of older adults who fell and were admitted to hospitals will still be alive within one year[10]
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