title: Risk factors associated with in-hospital mortality in elderly patients admitted to a regional trauma center after sustaining a fall.
abstract: OBJECTIVE
  Falls are a significant cause of mortality in the elderly patients. Despite this, the literature on in-hospital mortality related to elderly falls remains sparse. Our study aims to determine the risk factors associated with in-hospital mortality in elderly patients admitted to a regional trauma center after sustaining a fall.
  
  
  METHODS
  All elderly case records with fall-related injuries between 2003 and 2013 were retrospectively analyzed for demographic characteristics, injury severities, comorbidity factors and clinical outcomes. Logistic regression analysis was used to examine the risk factors associated with in-hospital mortality.
  
  
  RESULTS
  In total, 1026 elderly patients with fall-related injuries were included in the study. The average age of patients was 80.94 ± 8.16 years. Seventy seven percent of the patients had at least one comorbid condition. Majority of the falls occurred at home. More than half of the patients fell from ground level. Overall, the in-hospital mortality rate was 16 %. Head injury constituted the most common injury sustained in patients who died (77 %). In addition to age, ISS, GCS, ICU admission and anemia were significantly (P < 0.05) associated with in-hospital deaths in elderly fall patients.
  
  
  CONCLUSIONS
  Ground-level falls in the elderly can be devastating and carry a significant mortality rate. Elderly patients with anemia were two times more likely to die in the hospital after sustaining a fall in our study population. Increased focus on anemia which is often underappreciated in elderly fall patients can be beneficial in improving outcomes and reducing in-hospital mortality.
authors.affiliation: Department of Surgery, Nassau University Medical Center, East Meadow, NY, USA.
authors.forename: L J
authors.initials: LJ
authors.lastname: Cartagena
authors.affiliation: Department of Surgery, Nassau University Medical Center, East Meadow, NY, USA.
authors.forename: A
authors.initials: A
authors.lastname: Kang
authors.affiliation: Department of Emergency Medicine, Nassau University Medical Center, 2201 Hempstead Turnpike, East Meadow, NY, 11554, USA. smunnang@numc.edu.
authors.forename: S
authors.initials: S
authors.lastname: Munnangi
authors.affiliation: Department of Surgery, Nassau University Medical Center, East Meadow, NY, USA.
authors.forename: A
authors.initials: A
authors.lastname: Jordan
authors.affiliation: Department of Surgery, Nassau University Medical Center, East Meadow, NY, USA.
authors.forename: I C
authors.initials: IC
authors.lastname: Nweze
authors.affiliation: Department of Surgery, Nassau University Medical Center, East Meadow, NY, USA.
authors.forename: V
authors.initials: V
authors.lastname: Sasthakonar
authors.affiliation: Department of Emergency Medicine, Nassau University Medical Center, 2201 Hempstead Turnpike, East Meadow, NY, 11554, USA.
authors.forename: A
authors.initials: A
authors.lastname: Boutin
authors.affiliation: Department of Surgery, Nassau University Medical Center, East Meadow, NY, USA.|Department of Surgery, Kings County Hospital Center, Brooklyn, NY, USA.
authors.forename: L D
authors.initials: LD
authors.lastname: George Angus
mesh_terms: D000058:Accidental Falls / Q000401:mortality*; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D006259:Craniocerebral Trauma / Q000401:mortality; D005260:Female; D017052:Hospital Mortality; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D014193:Trauma Centers / Q000706:statistics & numerical data
keywords: Anemia; Elderly falls; Mortality; Risk factors