Gender differences for nonfatal unintentional fall-related injuries

National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA.
Injury Prevention (Impact Factor: 1.89). 05/2005; 11(2):115-9. DOI: 10.1136/ip.2004.005835
Source: PubMed


To quantify gender differences for non-fatal unintentional fall related injuries among US adults age 65 years and older treated in hospital emergency departments (EDs).
The authors analyzed data from a nationally representative sample of ED visits for January 2001 through December 2001, available through the National Electronic Injury Surveillance System All Injury Program (NEISS-AIP). For each initial ED visit, coders record one principal diagnosis (usually the most severe) and one primary part of the body affected.
Based on 22,560 cases, an estimated 1.64 million older adults were treated in EDs for unintentional fall injuries. Of these, approximately 1.16 million, or 70.5%, were women. Fractures, contusions/abrasions, and lacerations accounted for more than three quarters of all injuries. Rates for injury diagnoses were generally higher among women, most notably for fractures which were 2.2 times higher than for men. For all parts of the body, women's injury rates exceeded those of men. Rate ratios were greatest for injuries of the leg/foot (2.3), arm/hand (2.0), and lower trunk (2.0). The hospitalization rate for women was 1.8 times that for men.
Among older adults, non-fatal fall related injuries disproportionately affected women. Much is known about effective fall prevention strategies. We need to refine, promote, and implement these interventions. Additional research is needed to tailor interventions for different populations and to determine gender differences in the underlying causes and/or circumstances of falls. This information is vital for developing and implementing targeted fall prevention strategies.

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    • "The results of another Finnish study indicate that the elderly, especially older men are more likely to falls as they age (Lehtola et al. 2006). However, some other studies concerning gender differences in falls reveal that elderly women are more at risk of falling than men (Yasumura et al. 1994; Marcela and Dourado 2012; Stevens and Sogolow 2005). Saveman and Björnstig (2011), in their study on unintentional injuries among elderly population in north of Sweden, show that senior citizens aged 85 years and older are three times as likely as those aged 65–74 to experience injuries. "
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    ABSTRACT: This study assesses the nature and the geography of elderly injuries in Sweden. The most dominant types of accidents affecting the elderly in their homes and near environments are identified by using county-specific data from 2001 to 2010 followed by a correlation analysis of possible environmental factors underlying patterns of falls among the elderly. Geographical information systems are used to map rates by type. Slipping, tripping and stumbling are the causes of more than half of cases of elderly falls in Sweden, and is more typical in the Northern counties. Findings also show there has been a rise in rates of elderly falls since 2001 in most of the Southern counties, especially in O¨ stergo¨tland and Ska°ne Counties. Population age and gender affect the ecology of geography of fall rates and counties experiencing long cold winters tend to show higher rates of indoor falls than those with warmer temperature across the year. The article finalizes with a discussion of the results and implication for future researc
    GeoJournal 08/2014; 80(2). DOI:10.1007/s10708-014-9552-z
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    • "Young-adult males have been more exposed to road related accidents, while females in old age have been principally victims of unintentional domestic injuries. These results are consistent with other epidemiologic surveys [25-27]. Moreover, the age of injured females has been higher for all causes of injury and the same has been also observed in fatal trauma. "
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    ABSTRACT: Injury is a public health problem in terms of mortality, morbidity and disability. The implementation of a regionalised trauma system has been proved to significantly reduce the social impact of severe trauma on population. A population-based registry may be useful to obtain reliable epidemiologic data.Aim: To perform an exhaustive analysis of severe trauma patients hospitalised in Lombardia, a region of northern Italy.Materials and methods: The regional Hospital Discharge Registry (HDR) was used to retrieve data of all patients who suffered from serious injuries from 2008 to 2010. ICD9-CM codes of discharge diagnoses were analysed and patients coded from 800.0 to 939.9 or from 950.0 to 959.9 have been retrieved. Femur fractures in elderly and patients with length of hospital stay less than 2 days were excluded. Patients have been considered seriously injured if discharged dead or any of followings: admission or transit in ICU, need of mechanical ventilation, tracheotomy, invasive hemodynamic monitoring. Average reimbursement based on DRG has been evaluated.Statistics: Student's t test, ANOVA for continuous data, chi-square test for categorical data were used, and a p value less than 0.05 was considered significant. The severely injured patients hospitalised in Lombardia in three years were 11704, 391 per million per year. Overall mortality was 24.17% and increased with age. Males aging from 18 to 64 years had more occupational injuries, trauma on the road and violence by others. Females were more susceptible to domestic injuries and self inflicted violence, mostly in older ages. Acute mortality was higher after traffic accidents, while late mortality was increased in domestic trauma. Pediatric cases were unusual. A significant increase (+10.18%) in domestic trauma, with a concomitant decrease (-17.76%) in road-related accidents was observed in the three years study period. Rembursement paid to hospitals for seriously injured was insufficient with regard to estimated costs of care. Serious injury requiring hospitalisation in Lombardia is still an healthcare problem, with a trend toward a decrease of traffic accidents, increase in domestic trauma and involvement of older people. These results may help to plan a new regionalised Trauma System.
    World Journal of Emergency Surgery 08/2013; 8(1):32. DOI:10.1186/1749-7922-8-32 · 1.47 Impact Factor
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    • "In 2005, 15,802 patients aged 65 and older died as the result of fall-related injuries [1]. The direct medical costs for fall-related injuries was estimated to be $19 billion in 2000 [3] and the burden of fall-related injuries is expected to grow such that by the year 2020, the total cost is estimated to become approximately $54.9 billion [4]. External perturbations such as tripping (an unexpected deceleration of the foot causing imbalance) and slipping (an unexpected acceleration of the foot causing imbalance) are a major contributor to falls. "
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    ABSTRACT: Falls are the leading cause of fatal and non-fatal injuries among older adults. Exercise programs appear to reduce fall risk, but the optimal type, frequency, and duration of exercise is unknown. External perturbations such as tripping and slipping are a major contributor to falls, and task-specific perturbation training to enhance dynamic stability has emerged as a promising approach to modifying fall risk. The purpose of this pilot study was 1) to determine the feasibility of conducting a large pragmatic randomized trial comparing a multidimensional exercise program inclusive of the surface perturbation treadmill training (SPTT) to multidimensional exercise alone (Standard PT); and 2) to assess fall outcomes between the two groups to determine whether an effect size large enough to warrant further study might be present. A randomized pilot study at two outpatient physical therapy clinics. Participants were over age 64 and referred for gait and balance training. Feasibility for a larger randomized trial was assessed based on the ability of therapists to incorporate the SPTT into their clinical practice and acceptance of study participation by eligible patients. Falls were assessed by telephone interview 3 months after enrollment. Of 83 patients who were screened, 73 met inclusion criteria. SPTT was successfully adapted into clinical practice and 88% of eligible subjects were willing to be randomized, although 10% of the SPTT cohort dropped out prior to treatment. The SPTT group showed fewer subjects having any fall (19.23% vs. 33.33% Standard PT; p < 0.227) and fewer having an injurious fall (7.69% vs. 18.18%; p < 0.243). These results were not statistically significant but this pilot study was not powered for hypothesis testing. Physical therapy inclusive of surface perturbation treadmill training appears clinically feasible, and randomization between these two PT interventions is acceptable to the majority of patients. These results appear to merit longer-term study in an adequately powered trial. Trial registration NCT01006967
    BMC Geriatrics 05/2013; 13(1):49. DOI:10.1186/1471-2318-13-49 · 1.68 Impact Factor
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