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Semi-quantitative Assessment Using [18F]FDG Tracer in Patients with Severe Brain Injury
Published on: November 9, 2018
Mortality following ground-level falls in trauma patients with dementia
Renee C Groechel1, Gina M Berg2, Robert Joseph Sliter2
1Trauma Research, Swedish Medical Center, Englewood, Colorado, USA.
Objective:
Dementia and falls are strongly associated, yet few studies have investigated outcomes in patients with dementia after falling. We evaluated differences in mortality, defined as in-hospital mortality or discharge to hospice, and additional outcomes in ground-level fall (GLF) patients with and without dementia.
Methods:
Patients ≥65 years old were identified from the National Trauma Data Bank (2019-2022). Preliminary analyses examined characteristics between patients with and without pre-existing cases of dementia, documented at hospital admission. Upon identifying GLFs as the leading cause of hospital admission in patients with dementia, 1:1 propensity score-matched (PSM) models were used to examine outcomes in GLF patients with and without dementia.
Results:
A total of 1 789 794 patients were included in the preliminary sample and 286 648 (16.0%) had dementia. Of 286 648 patients with dementia, 53.6% were admitted for GLFs. The PSM population consisted of 151 577 matched pairs of GLF patients with and without dementia. After matching, patients with dementia had significantly greater mortality (9.8% vs 6.3%, absolute risk difference (ARD) (95% CI) 3.5 percentage points (3.3 to 3.7); p<0.001) compared with patients without dementia. The proportion of patients with in-hospital mortality no longer significantly differed, but discharge to hospice remained significantly greater in patients with dementia (6.2% vs 2.7%, ARD (95% CI) 3.5 percentage points (3.3 to 3.7); p<0.001) compared with those without dementia. A greater proportion of patients with dementia were discharged to skilled nursing facilities or long-term care hospitals (40.6% vs 37.5%, p<0.001) and less were discharged to inpatient rehab or short-term care facilities (12.2% vs 18.1%, p<0.001) compared with those without dementia.
Conclusions:
Findings from this retrospective study provide strong evidence that GLFs pose a significant health risk to patients with dementia. Implementing routine cognitive, exercise and fall-risk assessments in this population is needed.
Level Of Evidence:
III.
