title: Geriatric nursing home falls: A single institution cross-sectional study.
abstract: BACKGROUND
  Falls are the leading cause of fatal injury in geriatric patients. Nursing home falls occur at twice the rate of community falls, yet few studies have compared these groups. We hypothesized that nursing home residents admitted for fall would be sicker than their community counterparts on presentation and have worse outcomes.
  
  
  METHODS
  Records of 1708 patients, age 65 years and older with a documented nursing home status, admitted to our center between 2008 and 2012 were reviewed. Clinical data including injury severity score (ISS), admission Glasgow coma scale (GCS), in-hospital complications, length of stay (LOS), and in-hospital mortality were collected. Continuous data were analyzed using Mann-Whitney tests and categorical data using Fisher exact tests. Variables in the univariate tests were analyzed in a multivariate logistic regression.
  
  
  RESULTS
  Nursing home patients were older than community patients, presented with lower GCS, lower hemoglobin, higher international normalized ratio (INR) and a higher percentage of patients with body mass index (BMI)<18.5. LOS for nursing home patients was longer, and they suffered higher rates of in-hospital complications. ISS, rates of traumatic brain injury, operative intervention and mortality were not significantly different. In a multivariate logistic regression, ISS, GCS and age, but not nursing home status, were significant predictors of in-hospital mortality.
  
  
  CONCLUSIONS
  In comparison to their community counterparts, nursing home patients presenting after fall are more debilitated and have increased morbidity as evidenced by more in-house complications and increased LOS. However, nursing home residency was not a significant predictor of mortality.
authors.affiliation: Montefiore Medical Center, Albert Einstein College of Medicine and Jacobi Medical Center, Department of Surgery, 111 East 210th Street, Bronx, NY 10467, United States. Electronic address: Isadora.Botwinick@gmail.com.
authors.forename: Isadora
authors.initials: I
authors.lastname: Botwinick
authors.affiliation: Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY 10461, United States. Electronic address: Joshua.Johnson@med.einstein.yu.edu.
authors.forename: Joshua H
authors.initials: JH
authors.lastname: Johnson
authors.affiliation: Albert Einstein College of Medicine and Jacobi Medical Center, Department of Surgery, 1400 Pelham Parkway South, Bronx, NY 10461, United States. Electronic address: Saman.Safadjou@NBHN.net.
authors.forename: Saman
authors.initials: S
authors.lastname: Safadjou
authors.affiliation: Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY 10461, United States. Electronic address: Wayne.Cohen-Levy@med.einstein.yu.edu.
authors.forename: Wayne
authors.initials: W
authors.lastname: Cohen-Levy
authors.affiliation: Albert Einstein College of Medicine and Jacobi Medical Center, Department of Surgery, 1400 Pelham Parkway South, Bronx, NY 10461, United States. Electronic address: Srinivas.H.Reddy@NBHN.net.
authors.forename: Srinivas H
authors.initials: SH
authors.lastname: Reddy
authors.affiliation: Albert Einstein College of Medicine and Jacobi Medical Center, Department of Surgery, 1400 Pelham Parkway South, Bronx, NY 10461, United States. Electronic address: John.McNelis@NBHN.net.
authors.forename: John
authors.initials: J
authors.lastname: McNelis
authors.affiliation: Albert Einstein College of Medicine and Jacobi Medical Center, Department of Surgery, 1400 Pelham Parkway South, Bronx, NY 10461, United States. Electronic address: Sheldon.Teperman@NBHN.net.
authors.forename: Sheldon H
authors.initials: SH
authors.lastname: Teperman
authors.affiliation: Albert Einstein College of Medicine and Jacobi Medical Center, Department of Surgery, 1400 Pelham Parkway South, Bronx, NY 10461, United States. Electronic address: Melvin.Stone@NBHN.net.
authors.forename: Melvin E
authors.initials: ME
authors.lastname: Stone
mesh_terms: D000058:Accidental Falls / Q000401:mortality / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D005851:Geriatric Nursing; D015600:Glasgow Coma Scale; D006707:Homes for the Aged; D017052:Hospital Mortality; D006801:Humans; D015601:Injury Severity Score; D007902:Length of Stay / Q000706:statistics & numerical data*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009735:Nursing Homes
keywords: Fall; In-hospital mortality; Nursing home