[Falls in the elderly: analysis of potential risk based on observations in 1994-2001]

In medicine a fall is commonly construed as a sudden and totally accidental loss of postural balance, be that whilst walking or pursuing any other physical activities, in result of which a victim falls directly onto the ground, floor, or any other low-sited surface area. Frequency of falls in the elderly breaks down into 33% in the outpatients, 20% in the hospitalised patients and 45% in the nursing home residents. Data regarding the actual frequency of falls often misrepresent the facts, as most falls do not result in severe complications, although frequently enough facilitate development of post-fall syndrome and in due course in manifest deterioration of patients' overall mobility, thus making them even more prone to prospective falls. Around 10-15% of falls results in serious, life-threatening trauma. Immobilisation of a patient in the wake of a serious fall brings about a potential threat of venous thrombosis, pulmonary embolism, dehydration, muscular contracture and bed sores. Consequently, more frequent and prolonged hospitalisation is required, whereas a patient becomes steadily more care-dependent. By far the most frequent consequences of falls are bone fractures (50%), the ones sustained within the upper femoral bone area considered the most serious. Mortality resultant from post-fall complications tends to increase significantly with every decade of age. In full consideration of the above issues the present study aimed to assess the potential risk of accidental falls in the elderly, and therefore the falls sustained by 571 residents (aged 68-93 years) of two nursing homes in Krakow throughout 1994-2001 were subject to detailed analysis. The data yielded comprehensive information on the accompanying circumstances (i.e. specific location, timing, prevalent situation) within each one of the studied groups, thus facilitating development of the appropriate preventive measures. Studies comprehensively addressing the issue of accidental falls in the elderly and the attendant medical care costs sustained by the public health system are still very scarce in Poland, although the problem definitely merits further studies and an in-depth investigation, especially in consideration of the on-going restructuring within the country's medical service sector.