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Geriatric Falls: A Registry-Based Study in the Netherlands
Frank H O Verbeek1, Wietske H W Ham, André L M Verbeek
1School of Health Studies, HAN University of Applied Sciences, Nijmegen, the Netherlands (Mr Verbeek); Institute of Nursing Studies, University of Applied Sciences, and Emergency Department, University Medical Center Utrecht, Utrecht, the Netherlands (Dr Ham); Department for Health Evidence, Radboud University Medical Center, Nijmegen, the Netherlands (Dr Verbeek); Julius Center for Health Science and Primary Care, and Program in Clinical Health Sciences, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands (Dr de Man-van Ginkel); School of Health, Saxion University of Applied Sciences, Deventer/Enschede, the Netherlands (Dr van Os-Medendorp); Julius Center for Health Science and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands (Dr Westers); and Department of Surgery, University Medical Center Utrecht, Utrecht, the Netherlands (Dr Leenen).
Background:
Falls in people 65 years and older evaluated in the emergency department are increasing. Of all unintentional injury-related deaths among older people, 55% are due to falls. The impact of falls, especially concerning Dutch older people with the highest proportion of living independently worldwide, is unclear.
Objective:
To identify the influence of age, gender, health conditions, and type of fall on the severity of injury, hospital length of stay, mortality, and discharge destination.
Methods:
A total number of 6,084 patients from a comprehensive regional trauma care system, 65 years and older and hospitalized after a fall, were included. Groups were compared for patient-related factors and multivariable logistic regression analysis to explore the consequences.
Results:
Mean age was 82 years (SD = 8.3), and 70% were female. Most falls (66.4%) were due to "slipping and tripping" or "falls on the same level," 57.4% had Injury Severity Scores between 9 and 12, and 43.3% were discharged home. Higher age and type of fall increased the likelihood of severe injuries. Men experienced shorter hospital stays than women and were less frequently discharged home. Mortality was higher in males (10.8%) than in females (6.7%) and increased with the American Society of Anesthesiologists scores for preexisting health conditions.
Conclusion:
Advanced age, gender, type of fall, and prior health status play a significant role in the severity of injuries, length of hospital stay, 30-day mortality, and higher discharge destination to care homes in older people hospitalized after a fall.
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