Abstract
BACKGROUND: As the population ages, mortality from falls will soon exceed that from all other forms of injury. Tremendous resources are focused on this problem, but how these patients die is unclear. To fill this gap, we tested the hypothesis that falls among the elderly are related to patient, rather than to injury factors when compared with falls among younger adults. METHODS: From January 2002 to December 2012, 7,293 fall admissions were reviewed. Data are reported as mean ± SD if normally distributed or median (interquartile range) if not. RESULTS: In 2002 to 2007, 25% of all falls were in elderly patients (≥65 years), but in 2008 to 2012, this proportion increased to 30% ( p <0.001). When comparing adult (n = 5,216) with elderly (n = 2,077) admissions, characteristics were as follow: Injury Severity Score (ISS) of 8 (4-13) versus 9 (5-17), length of stay (in days) of 3 (1-7) versus 6 (2-11), and mortality of 3.8% versus 13.7% (all p <0.001). After controlling for variables associated with mortality using multiple logistic regression, elderly age was the strongest independent predictor of mortality (odds ratio, 8.18; confidence interval, 4.88-13.71). When comparing adult (n = 198) with elderly (n = 285) fatalities, ground-level falls occurred in 31% versus 91%, ISS was 27 (25-41) versus 25 (16-36), and length of stay (in days) was 2 (0-6) versus 4 (1-11) (all p <0.001). Death occurred directly from fall in 82% versus 63%, from complications in 10% versus 20%, and from a fatal event preceding the fall in 8% vs. 17% (all p <0.001). CONCLUSION: The proportion of fall admissions in the elderly is growing in this trauma system. Elderly age is the strongest independent predictor of mortality following a fall. In thosewho die, death is less likely a direct effect of the fall.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 617-621 |
| Number of pages | 5 |
| Journal | Journal of Trauma and Acute Care Surgery |
| Volume | 79 |
| Issue number | 4 |
| DOIs | |
| State | Published - 2015 |
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Keywords
- Epidemiology of trauma deaths
- Geriatrics
- Trauma systems
ASJC Scopus subject areas
- Critical Care and Intensive Care Medicine
- Surgery
Cite this
Causes of death differ between elderly and adult falls. / Allen, Casey J.; Hannay, William M.; Murray, Clark R.; Straker, Richard J.; Hanna, Mena M.; Meizoso, Jonathan P.; Ray, Juliet J.; Livingstone, Alan; Schulman, Carl I; Namias, Nicholas; Proctor, Kenneth G.
In: Journal of Trauma and Acute Care Surgery, Vol. 79, No. 4, 2015, p. 617-621.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Causes of death differ between elderly and adult falls
AU - Allen, Casey J.
AU - Hannay, William M.
AU - Murray, Clark R.
AU - Straker, Richard J.
AU - Hanna, Mena M.
AU - Meizoso, Jonathan P.
AU - Ray, Juliet J.
AU - Livingstone, Alan
AU - Schulman, Carl I
AU - Namias, Nicholas
AU - Proctor, Kenneth G
PY - 2015
Y1 - 2015
N2 - BACKGROUND: As the population ages, mortality from falls will soon exceed that from all other forms of injury. Tremendous resources are focused on this problem, but how these patients die is unclear. To fill this gap, we tested the hypothesis that falls among the elderly are related to patient, rather than to injury factors when compared with falls among younger adults. METHODS: From January 2002 to December 2012, 7,293 fall admissions were reviewed. Data are reported as mean ± SD if normally distributed or median (interquartile range) if not. RESULTS: In 2002 to 2007, 25% of all falls were in elderly patients (≥65 years), but in 2008 to 2012, this proportion increased to 30% ( p <0.001). When comparing adult (n = 5,216) with elderly (n = 2,077) admissions, characteristics were as follow: Injury Severity Score (ISS) of 8 (4-13) versus 9 (5-17), length of stay (in days) of 3 (1-7) versus 6 (2-11), and mortality of 3.8% versus 13.7% (all p <0.001). After controlling for variables associated with mortality using multiple logistic regression, elderly age was the strongest independent predictor of mortality (odds ratio, 8.18; confidence interval, 4.88-13.71). When comparing adult (n = 198) with elderly (n = 285) fatalities, ground-level falls occurred in 31% versus 91%, ISS was 27 (25-41) versus 25 (16-36), and length of stay (in days) was 2 (0-6) versus 4 (1-11) (all p <0.001). Death occurred directly from fall in 82% versus 63%, from complications in 10% versus 20%, and from a fatal event preceding the fall in 8% vs. 17% (all p <0.001). CONCLUSION: The proportion of fall admissions in the elderly is growing in this trauma system. Elderly age is the strongest independent predictor of mortality following a fall. In thosewho die, death is less likely a direct effect of the fall.
AB - BACKGROUND: As the population ages, mortality from falls will soon exceed that from all other forms of injury. Tremendous resources are focused on this problem, but how these patients die is unclear. To fill this gap, we tested the hypothesis that falls among the elderly are related to patient, rather than to injury factors when compared with falls among younger adults. METHODS: From January 2002 to December 2012, 7,293 fall admissions were reviewed. Data are reported as mean ± SD if normally distributed or median (interquartile range) if not. RESULTS: In 2002 to 2007, 25% of all falls were in elderly patients (≥65 years), but in 2008 to 2012, this proportion increased to 30% ( p <0.001). When comparing adult (n = 5,216) with elderly (n = 2,077) admissions, characteristics were as follow: Injury Severity Score (ISS) of 8 (4-13) versus 9 (5-17), length of stay (in days) of 3 (1-7) versus 6 (2-11), and mortality of 3.8% versus 13.7% (all p <0.001). After controlling for variables associated with mortality using multiple logistic regression, elderly age was the strongest independent predictor of mortality (odds ratio, 8.18; confidence interval, 4.88-13.71). When comparing adult (n = 198) with elderly (n = 285) fatalities, ground-level falls occurred in 31% versus 91%, ISS was 27 (25-41) versus 25 (16-36), and length of stay (in days) was 2 (0-6) versus 4 (1-11) (all p <0.001). Death occurred directly from fall in 82% versus 63%, from complications in 10% versus 20%, and from a fatal event preceding the fall in 8% vs. 17% (all p <0.001). CONCLUSION: The proportion of fall admissions in the elderly is growing in this trauma system. Elderly age is the strongest independent predictor of mortality following a fall. In thosewho die, death is less likely a direct effect of the fall.
KW - Epidemiology of trauma deaths
KW - Geriatrics
KW - Trauma systems
UR - http://www.scopus.com/inward/record.url?scp=84942592012&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84942592012&partnerID=8YFLogxK
U2 - 10.1097/TA.0000000000000811
DO - 10.1097/TA.0000000000000811
M3 - Article
C2 - 26402536
AN - SCOPUS:84942592012
VL - 79
SP - 617
EP - 621
JO - Journal of Trauma and Acute Care Surgery
JF - Journal of Trauma and Acute Care Surgery
SN - 2163-0755
IS - 4
ER -