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. 2019;2(1):30.
doi: 10.28933/ijoar-2018-12-2305.

Risks factors for significant injury after geriatric falls

Jon D Dorfman  1 , Allison Wyman  2 , Gordon FitzGerald  2 , Timothy A Emhoff  1 , Fred A Anderson  2 , Heena P Santry  3
Affiliations

Risks factors for significant injury after geriatric falls

Jon D Dorfman et al. Int J Aging Res. 2019.

Abstract

Elderly falls are a healthcare epidemic. We aimed to identify risk factors of serious falls by linking data on functional status from the Global Longitudinal Study of Osteoporosis in Women (GLOW) and our institutional trauma registry. 124 of 5,091 local women enrolled in GLOW were evaluated by our trauma team for injuries related to a fall during the study period. Median injury severity score was 9. The most common injuries were intertrochanteric femur fracture (n = 25, 9.8%) and skin contusion/hematoma to face (n = 12, 4.7%). Injured women were older than the uninjured cohort (median 80 versus 68 years), more likely to have cardiovascular disease and osteoarthritis, and less likely to have high cholesterol. Prospectively collected Short Form 36 (SF-36) baseline activity status revealed greater limitation in all assessed activities in women evaluated for fall-related injuries in our trauma center. In multivariable analysis, age (per 10 year increase) and two or more self-reported falls in the baseline survey were the strongest predictors of falling (both HR 2.4, p <0.0001 and p<0.001 respectively), followed by history of osteoarthritis (HR 1.6, p= 0.01). Functional status was no longer associated with risk of fall when adjusting for these factors. Functional status appears to be a surrogate marker for frailty. With the aging of the US population and long lifespan of American women, this finding has important implications for both fall prevention strategies and research intended to better understand why aging women fall as burdensome validated metrics may not be the best indicators of fall risk.

Keywords: falls; geriatric; trauma.

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Conflict of interest statement

The authors have no conflict of interests to declare.

Figures

Figure 1a.
Figure 1a.
Kaplan-Meier Curve for Fall-Based Trauma Activation
Figure 1b.
Figure 1b.
Kaplan-Meier Curve for Fall-Based Trauma Activation by increasing age (10 year increments)
Figure 1c.
Figure 1c.
Kaplan-Meier Curve for Fall-Based Trauma Activation by number of self reported falls.
Figure 1d.
Figure 1d.
Kaplan-Meier Curve for Fall-Based Trauma Activation by SF-36 physical function quartile.
Figure 2.
Figure 2.
Short Form 36 Activity from the GLOW Baseline Survey (all differences significant p < 0.05)
See this image and copyright information in PMC

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