Geriatric hospitalizations in fall-related injuries.
BACKGROUND
To investigate the injury pattern, severity, and mortality of elderly patients hospitalized for treatment of trauma following fall accidents.


METHODS
Data obtained from the Trauma Registry System were retrospectively reviewed for trauma admissions between January 1, 2009 and December 31, 2013 in a Level I trauma center. Of 16,548 registered patients, detailed information was retrieved from the 2,403 elderly patients (aged 65 years and above) with fall accidents and was compared with information from 1,909 adult patients (aged 20-64) with fall accidents.


RESULTS
Falls presented the major mechanism for admission (59.9%) in the elderly patients. The number of elderly patients who fell from a height <1 m was greater than that of the adult patients (91.9% vs. 62.5%, respectively, p <0.001). The Injury Severity Score (ISS) (9.3 ± 4.4 vs. 8.3 ± 6.1, respectively, p =0.007) and New Injury Severity Score (NISS) (10.3 ± 6.8 vs. 9.5 ± 8.2, respectively, p <0.001) were significantly higher in the elderly than the adult patients. A significantly larger proportion of the elderly patients were admitted to the ICU (16.2% vs. 13.4%, respectively, p =0.009), and the elderly were found to have longer stays in the intensive care unit (ICU) (8.6 days vs. 7.6 days, respectively, p =0.034) but not in the hospital in general (9.6 days vs. 8.5 days, respectively, p =0.183). Additionally, a significantly higher percentage of the elderly patients sustained subdural hematoma (10.1% vs. 8.2%, respectively, p =0.032) and femoral fracture (50.6% vs. 14.1%, respectively, p <0.001). There were significant differences in in-hospital mortality (18.2% vs. 10.3%, respectively, p =0.031) and length of stay in the hospital (11.6 days vs. 14.9 days, respectively, p =0.037) between the elderly and adult patients with subdural hematoma, but not between those with femoral fracture.


CONCLUSIONS
Analysis of the data indicates that elderly patients hospitalized for treatment of trauma following fall accidents present with a bodily injury pattern that differs from that of adult patients and have a higher severe injury score, worse outcome, and higher mortality than those of adult patients.
Department of Neurourgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung City, Taiwan. ersh2127@adm.cgmh.org.tw.
Cheng-Shyuan
CS
Rau
Department of Trauma Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, No.123, Ta-Pei Road, Niao-Song District, Kaohsiung City, 833, Taiwan. tslin51@yahoo.com.tw.
Tsan-Shiun
TS
Lin
Department of Anesthesiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung City, Taiwan. shaochunwu@gmail.com.
Shao-Chun
SC
Wu
Department of Plastic and Reconstructive Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung City, Taiwan. johnson.c.yang@gmail.com.
Johnson Chia-Shen
JC
Yang
Department of Trauma Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, No.123, Ta-Pei Road, Niao-Song District, Kaohsiung City, 833, Taiwan. ah.lucy@hotmail.com.
Shiun-Yuan
SY
Hsu
Department of Trauma Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, No.123, Ta-Pei Road, Niao-Song District, Kaohsiung City, 833, Taiwan. pecarol@gmail.com.
Tzu-Yu
TY
Cho
Department of Trauma Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, No.123, Ta-Pei Road, Niao-Song District, Kaohsiung City, 833, Taiwan. m93chinghua@gmail.com.
Ching-Hua
CH
Hsieh
D000058:Accidental Falls / Q000706:statistics & numerical data*; D000328:Adult; D000368:Aged; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D017052:Hospital Mortality / Q000639:trends; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D015601:Injury Severity Score; D007902:Length of Stay / Q000639:trends; D008297:Male; D008875:Middle Aged; D012042:Registries; D012189:Retrospective Studies; D013624:Taiwan / Q000453:epidemiology; D014193:Trauma Centers / Q000706:statistics & numerical data*; D014947:Wounds and Injuries / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D055815:Young Adult