title: Falls requiring medical attention among veterans with multiple sclerosis: a cohort study.
abstract: The purpose of this study was to estimate the relative risk of an injurious fall requiring medical attention in veterans with multiple sclerosis (MS) compared with veterans without MS after controlling for sex, age, and healthcare use. The sample included 195,417 veterans treated at Veterans Health Administration (VHA) facilities in the Northwest United States in fiscal year 2008. We obtained information regarding MS diagnosis, injurious falls (operationalized as International Classifi cation of Diseases-9th Revision-Clinical Modification codes E880-E888), and demographic and healthcare use data from the VHA Consumer Health Information Performance Set database. Using logistic regression, we determined the adjusted odds ratio (OR) of an injurious fall to be three times higher in female veterans with MS than in female veterans without MS (OR = 3.0, 95% confidence interval [CI] = 1.6-5.5). The adjusted OR of an injurious fall for men with MS was also higher than for men without MS, but this difference was not statistically significant (OR = 1.2, 95% CI = 0.8-2.1). We recommend further studies evaluating the medical, social, and economic consequences of injurious falls, as well as interventions to prevent injurious falls, to improve the independence and quality of life of veterans and others living with MS.
authors.affiliation: Neurology Service and Multiple Sclerosis Center of Excellence—West, Portland Department of Veterans Affairs Medical Center and Department of Neurology, Oregon Health & Science University, Portland, OR 97239, USA. cameromi@ohsu.edu
authors.forename: Michelle H
authors.initials: MH
authors.lastname: Cameron
authors.forename: Amy J
authors.initials: AJ
authors.lastname: Poel
authors.forename: Jodie K
authors.initials: JK
authors.lastname: Haselkorn
authors.forename: Alex
authors.initials: A
authors.lastname: Linke
authors.forename: Dennis
authors.initials: D
authors.lastname: Bourdette
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications* / Q000503:physiopathology; D016017:Odds Ratio; D012307:Risk Factors; D017678:Sex Distribution; D014481:United States / Q000453:epidemiology; D014728:Veterans / Q000706:statistics & numerical data*; D014947:Wounds and Injuries / Q000453:epidemiology*; D055815:Young Adult