Risk Factors for Traumatic Brain Injuries During Falls in Older Persons

To identify risk factors for traumatic brain injuries (TBIs) during falls in older Taiwanese people.

Case patients consisted of 113 patients aged 60 years or older with a moderate/severe TBI due to a fall. Two control groups: (1) 339 older patients with a soft-tissue injury; and (2) 113 with a mild-TBI due to a fall. Proxies were required to provide information for a considerable number of patients.

Matched case-control study.

The emergency departments of 3 general hospitals.

Sociodemographic, lifestyle behavior, chronic condition, medication use, functional abilities, and fall-related characteristics.

When patients with a soft-tissue injury were assigned to the control group, men were 2.06-fold more likely to have a moderate/severe TBI than women. Subjects who took antiarrhythmics within 4 hours of a fall were 2.59-fold more likely to have a moderate/severe TBI than those who took none. Subjects who were negotiating stairs and getting in/out of the bed/chair were 3.12-fold and 2.97-fold, respectively, more likely to have a moderate/severe TBI than those who fell while walking. Falling backward and sideways was 4.07-fold and 2.30-fold, respectively, more likely to cause a moderate/severe TBI than falling forward. When patients with a mild-TBI were assigned to the control group, results were similar, with the exception that the effect of antiarrhythmic use became nonsignificant and subjects who took 2 or more medications were 3.07-fold more likely to have a moderate/severe TBI than those who took none.

Avoiding a head impact during a backward or sideways fall, reducing unnecessary use of polypharmacy and antiarrhythmics, and maintaining safety during stair negotiation and bed/chair transfer may protect an elderly person from a severe brain injury.