title: Nationwide time trends and risk factors for in-hospital falls-related major injuries.
abstract: BACKGROUND
  Accidental falls during hospitalisation have a range of complications and more information is needed to improve prevention. We investigated patterns of in-hospital fall-related major injuries in the period 2000-2012 and the association between chronic conditions and in-hospital fall-related major injuries.
  
  
  METHODS
  Using administrative databases, patients aged 65+ years with in-hospital falls causing fractures or head injuries with need for surgery or intensive observation were identified as cases and were individually matched with five controls. Joinpoint regression was used to examine time trends and conditional logistic regression was used to analyse odds ratio (OR) for in-hospital falls-related major injuries according to a range of comorbidities.
  
  
  RESULTS
  Four thousand seven hundred and fifty-four cases were identified from 2000 to 2012 and the most common injury was femur fracture (61.55%). For individuals aged 65-74 and 75+ years, the incidence of in-hospital falls-related major injuries per 100,000 hospital days increased significantly in 2000-2012 (average annual change: 3.2%, CI: 0.6-5.8) and 2007-2012 (average annual change: 11.4%, CI: 5.7-17.5), respectively. Significantly increased OR for in-hospital fall-related major injuries were found for individuals with dementia (OR = 2.34, CI: 1.87-2.92), osteoporosis (OR = 1.68, CI: 1.43-1.99), stroke (OR = 1.63, CI: 1.41-1.88), depression (OR = 1.24, CI: 1.09-1.41), chronic obstructive pulmonary disease (OR = 1.18, CI: 1.01-1.39) and Parkinson disease (OR = 1.17, CI: 1.01-1.34).
  
  
  CONCLUSIONS
  In-hospital falls-related major injuries increased significantly during the study period. Elderly with dementia, osteoporosis, stroke, depression, chronic obstructive pulmonary disease and Parkinson disease were associated with increased OR for in-hospital fall-related major injuries. Increased focus on patients with these comorbidities is warranted to decrease the increasing incidence in in-hospital major injuries.
authors.affiliation: Department of Geriatric Medicine, Nykøbing-Falster Hospital, Nykøbing Falster, Denmark.
authors.forename: T S H
authors.initials: TS
authors.lastname: Jørgensen
authors.affiliation: Geriatric Section, Department of Internal Medicine, Slagelse Hospital, Slagelse, Denmark.
authors.forename: A H
authors.initials: AH
authors.lastname: Hansen
authors.affiliation: Department of Geriatric Medicine, Aalborg Hospital, Aalborg, Denmark.
authors.forename: M
authors.initials: M
authors.lastname: Sahlberg
authors.affiliation: Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup, Denmark.|Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.|National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark.
authors.forename: G H
authors.initials: GH
authors.lastname: Gislason
authors.affiliation: Institute of Health, Science and Technology, Aalborg University, Aalborg, Denmark.
authors.forename: C
authors.initials: C
authors.lastname: Torp-Pedersen
authors.affiliation: Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup, Denmark.
authors.forename: C
authors.initials: C
authors.lastname: Andersson
authors.affiliation: Department of Geriatric Medicine, Nykøbing-Falster Hospital, Nykøbing Falster, Denmark.
authors.forename: E
authors.initials: E
authors.lastname: Holm
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D002908:Chronic Disease; D006259:Craniocerebral Trauma / Q000209:etiology*; D003718:Denmark / Q000453:epidemiology; D005260:Female; D050723:Fractures, Bone / Q000209:etiology*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008297:Male; D012044:Regression Analysis; D012307:Risk Factors