title: Indoor and outdoor falls among older adult trauma patients: A comparison of patient characteristics, associated factors and outcomes.
abstract: OBJECTIVE
  The aim of the present study was to examine significant differences in patient characteristics, associated factors and outcomes for indoor versus outdoor falls among trauma patients.
  
  
  METHODS
  A retrospective cross-sectional study using data from the trauma registry and electronic medical records at a level 1 trauma center in the USA was carried out. People aged 55 years or older, for whom fall location could be identified (n = 712), were included in the study. Demographic information, functional status before admission, comorbid conditions, activation level, Injury Severity Score, discharge disposition and injury type were included in the comparative analyses. Associated factors for falls and fractures in each location were also examined using logistic regression.
  
  
  RESULTS
  Significant differences were found in patient characteristics between indoor and outdoor fallers. Significant differences in outcomes were found related to discharge disposition and injury type. Open wounds were more common among outdoor fallers (26.5%) as compared with indoor fallers (16.3%, P = 0.002). Although disorders of joints with difficulty walking were associated with fractures among both indoor (OR 7.20, CI 2.19-23.66) and outdoor fallers (OR 5.65, CI 1.27-25.06), sex was only associated with fractures among those who fell indoors (OR 1.69 CI 1.12-2.56).
  
  
  CONCLUSIONS
  Significant differences exist in characteristics of indoor and outdoor fallers, and for discharge disposition and injury type for each fall location among patients admitted for trauma care. Factors associated with fractures differ between indoor and outdoor fallers. Results can help to inform targeted primary and secondary prevention initiatives. Geriatr Gerontol Int 2017; 17: 905-912.
authors.affiliation: New York University, Steinhardt School of Culture, Education, and Human Development, Department of Occupational Therapy, New York, NY, USA.
authors.forename: Tracy
authors.initials: T
authors.lastname: Chippendale
authors.affiliation: Jamaica Hospital Medical Center, Department of Surgery, Jamaica, NY, USA.
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Gentile
authors.affiliation: Jamaica Hospital Medical Center, Department of Surgery, Jamaica, NY, USA.
authors.forename: Melissa K
authors.initials: MK
authors.lastname: James
authors.affiliation: New York Presbyterian Hospital, Department of Surgery, New York, NY, USA.
authors.forename: Gloria
authors.initials: G
authors.lastname: Melnic
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000368:Aged; D003430:Cross-Sectional Studies; D004777:Environment; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D014947:Wounds and Injuries / Q000453:epidemiology*
keywords: indoor falls; outdoor falls; patient outcomes; trauma care