Falls and dilemmas in injury prevention in older West Virginians

Abstract

Falls are the number one cause of injury-related morbidity and mortality in West Virginia senior citizens. Poor outcomes following falls are exacerbated by numerous comorbidities which are prevalent in the elderly population in West Virginia. This study describes the injury patterns, resource utilization and dispositions of WV seniors injured in a fall.

Methods: This is a descriptive retrospective cohort study utilizing the West Virginia State Trauma System registry; which collects trauma data from 33 acute care facilities in West Virginia.

Results: Data from 5498 cases were reviewed for patients enrolled in the Registry in 2010. Fall victims aged 65 and older were included. Most falls occurred in the home (75.2%) or in a residential institution (11.3%). Femur fractures (36.3%) and intracranial hemorrhages (8.2%) were the most common injury diagnoses. Disposition back home declined from 58.6% in the 60-65 age group to 20.9% returning home following falls in the age 90-94 group. Conversely, disposition to a skilled nursing facility rose from 20.1% in the age 60-65 group to 49.1% in the age 90-94 group. The case fatality rate for all the seniors enrolled in the trauma system was 3.3%.

Discussion: Fall was the mechanism of injury for 83.3% of traumatic injuries in persons over the age of 65 enrolled in the WV trauma system. Older West Virginians suffer from numerous comorbidities that increase the risk of fall as well as the severity of injuries from a fall.

Conclusion: In West Virginia, there is a correlation between increasing age and less desirable outcomes and dispositions from trauma centers for senior citizens after a fall. West Virginia patients, families and care providers must frequently face complicated treatment dilemmas, especially as the related risk of falling and the co-morbid conditions are commonly seen in older West Virginians. Multi-modal fall prevention programs can reduce the risk of falls in senior citizens.