Ground-level falls: 9-year cumulative experience in a regionalized trauma system

Area of Science:

• Trauma Surgery
• Geriatric Trauma
• Public Health

Background:

• Ground-level falls (GLFs) are a primary cause of nonfatal hospitalized injuries in the United States.
• Older adults are disproportionately affected by GLFs, leading to significant morbidity and healthcare utilization.

Purpose of the Study:

• To evaluate if risk-adjusted mortality rates for ground-level fall patients differ across trauma center verification levels.
• To assess the impact of regional triage systems on outcomes for GLF patients.

Main Methods:

• A retrospective analysis of a regional trauma registry from 2001-2009.
• Inclusion of 8202 patients who experienced ground-level falls.
• Application of a multilevel mixed-effects logistic regression model to compare risk-adjusted mortality.

Main Results:

• Patients treated at Level I trauma centers had a higher unadjusted probability of death (6.0%) compared to Level II (3.1%) and Level III/IV (1.1%) centers.
• Risk-adjusted mortality was lowest at Level I centers (OR 0.71), with no significant difference between Level II and Level III/IV centers.
• Risk-adjusted mortality for GLF patients showed minimal variation across trauma center levels from 2002 to 2009.

Conclusions:

• Regional risk-adjusted mortality for ground-level falls has remained relatively stable since 2002.
• The observed lower risk-adjusted mortality at Level I centers warrants further investigation.
• Findings suggest the importance of appropriate regional triage for optimizing outcomes in the growing population of older adults experiencing GLFs.