For elderly, even short falls can be deadly; Adults 70-plus three times as likely to die following low-level falls

93 and 2003, there was a 55 percent increase in the rate of fatal falls for elderly adults. Because of the increasing age in the general population, the number of elderly patients visiting the emergency department with ground-level falls is increasing, and will likely continue to rise in the future. It is now estimated that 30 percent of adults older than 65 years will experience an unintentional fall each year.

"Instead of an influx of 'traditional' knife-and-gun club victims, trauma centers of the future may need to prepare for treatment of a less dramatic but no less relevant form of injury that may very well have a substantial impact on the health and independence of our older citizens," said Thomas S. Helling, M.D., from the Department of Surgery at the University of Mississippi Medical Center who wrote an editorial accompanying the study.

The negative effect of age on health outcomes has been well established in past studies in other areas as well. Many elderly adults are frail and have pre-existing medical conditions, such as heart disease. In these types of patients, a low-level fall that results in a broken hip could have serious, far-reaching consequences. According to Cheng, "An 80 year old often can't tolerate and recover from trauma like a 20 year old."

Cheng's team found that approximately 4.5 percent of elderly patients (70 years and above) died following a ground-level fall, compared to 1.5 percent of non-elderly patients. Elderly patients remained in the hospital and the intensive care unit longer and only 22 percent were able to function on their own after they left the hospital, compared to 41 percent of non-elderly patients.

Though low-level falls can potentially lead to significant injury and death, the reality is that almost three-quarters of patients with ground-level falls are not severely injured. Given the limited resources available to most medical centers across the United States and the increasing number of elderly patients needing treatment, Cheng's team identified two major predictors of death in patients who have experienced ground-level falls: Age older than 70 years and a Glasgow Coma Scale (a widely used indicator of brain injury) score of less than 15. These specific factors may help emergency department staff better determine which patients have a higher risk of death and are more likely to require aggressive evaluation and treatment.

While more research is needed on the management and treatment of the ever-expanding subpopulation of elderly patients in trauma centers, Cheng emphasizes the need to focus on prevention as well.

"This study brings up the important question of what we need to do as a society to help our older folks take care of themselves," said Cheng. "Instead of just treating falls as they happen, the focus should be on what we can do to help older people avoid them in the first place. This can be as simple as making sure there is no loose carpeting in their home and putting railings on both sides of stairways and in bathtubs and showers."

In addition to Cheng, Konstantinos Spaniolas, M.D., Mark Gestring, M.D., Ayodele Sangosanya, M.D., Nicole Stassen, M.D. and Paul Bankey, M.D., from the University of Rochester Medical Center contributed to the study.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by University of Rochester Medical Center.

Journal Reference:

Konstantinos Spaniolas, Julius D. Cheng, Mark L. Gestring, Ayodele Sangosanya, Nicole A. Stassen, Paul E. Bankey. Ground Level Falls Are Associated With Significant Mortality in Elderly Patients. The Journal of Trauma: Injury, Infection, and Critical Care, 2010; 69 (4): 821 DOI: 10.1097/TA.0b013e3181efc6c6

Note: If no author is given, the source is cited instead.

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