Injuries sustained by falls.

Department of Surgery, University of Tennessee Medical Center, Knoxville 37920.
Archives of emergency medicine 01/1992; 8(4):245-52. DOI: 10.1136/emj.8.4.245
Source: PubMed

ABSTRACT During a recent 4-year period, 381 patients were admitted with injuries sustained from falls. Equal numbers of patients were less than and greater than 50 years of age and included 53 children (less than or equal to 16 years) and 214 elderly (greater than or equal to 55 years). Falls from heights occurred predominantly in young males (mean age 34.2 years), were most commonly job or recreation related and resulted in higher injury severity scores (ISS). Falls in the elderly occurred more commonly in women, typically on a flat surface, and were less severe. Despite lower mean ISS, fall victims over 55 years of age had longer hospitalizations (11.4 vs. 4.5 days) and incurred higher hospital charges compared to younger patients. There were 35 deaths (9.2%). In patients under 55 years, deaths resulted from fall-related central nervous system (CNS) injury and/or multisystem trauma. In patients over 55 years, fatalities were most commonly related to pre-existent medical conditions. Based on a review of this experience, we conclude that: (1) unlike other causes of blunt and penetrating trauma, both sexes are equally at risk from fall-related injuries but sex incidence is age related; (2) falls from heights are more common in men; (3) advanced age and pre-existing medical conditions account for the increased morbidity and mortality following falls and; (4) cost containment measures for fall-related trauma must consider not only injury severity, but the age and pre-existent medical conditions of the patient.

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    ABSTRACT: Background: Falls from ladders account for a significant number of hospital visits. However, the epidemiology, injury pattern, and how age affects such falls are poorly described in the literature. Materials and methods: Patients >= 18 y who suffered falls from ladders over a 51/2-y period were identified in our trauma registry. Dividing patients into three age groups (18-45, 46-65, and >66 y), we compared demographic characteristics, clinical data, and outcomes including injury pattern and mortality. The odds ratios (ORs) were calculated with the group 18-45 y as reference; group means were compared with one-way analysis of variance. Results: Of 27,155 trauma patients, 340 (1.3%) had suffered falls from ladders. The average age was 55 y, with a male predominance of 89.3%. Average fall height was 9.8 ft, and mean Injury Severity Score was 10.6. Increasing age was associated with a decrease in the mean fall height (P < 0.001), an increase in the mean Injury Severity Score (P < 0.05), and higher likelihood of admission (>66 y: OR, 5.3; confidence interval [CI], 2.5-11.5). In univariate analysis, patients in the >66-y age group were more likely to sustain traumatic brain injuries (OR, 3.4; CI, 1.5-7.8) and truncal injuries (OR, 3.6; CI, 1.9-7.0) and less likely to sustain hand and/or forearm fractures (OR, 0.3; CI, 0.1-0.9). Conclusions: Older people are particularly vulnerable after falling from ladders. Although they fell from lower heights, the elderly sustained different and more severe injury patterns. Ladder safety education should be particularly tailored at the elderly.
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    ABSTRACT: We investigated, by studying medical records, background factors and consequences of accidental falls of patients 65-74 years who attended the Department of Orthopedics' emergency clinic in Lund. We also assessed possible prevention measures. Fractures occurred in three quarters of the registered falls. Women were more prone to sustain fractures than men. Forearm fractures were commonest among women while hip fractures were commonest among men. One third of the patients were admitted to an orthopedic ward because of the fall. The patients who were less healthy had sustained fractures oftener and also needed more hospital care. Information regarding risk factors for falls and fractures were often missing in the patients' medical records. Impaired walking and balance, and medication increased the risk of falls. Such patients constitute a high risk group for future falls and fractures. A newly developed instrument is suggested as a routine in the emergency department to increase the awareness of risk factors for falls in the elderly. Satisfactory documentation is a prerequisite for further treatment and referrals to prevent falls and fractures.
    Acta Orthopaedica Scandinavica 05/2000; 71(2):175-9. DOI:10.1080/000164700317413157
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    ABSTRACT: Our objective was to analyze and determine several risk factors of falls in the rural elderly population. Our study examined several variables believed to be positively correlated with the likelihood of an elderly person sustaining a fall. Analysis was performed on a prospective study of 308 community-dwelling rural elders during a span of 6 years. Factors such as prescription medication, eyesight, age, sex, recent hospitalizations, and personal health ratings were analyzed through a series of advanced empirical techniques. Of the five significant variables found in our analysis, four were different types of prescription drugs. The biometric results suggest the probability of falling increases by as much as 4% for each year of age. Prescription painkillers increase the probability of falling by 20% to 85%. Arthritis medication decreases the probability of falling by 20% to 60%. Although our results are necessary to the body of falls research, further study is required for precise determination of those medications found to be statistically significant in our analysis.
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