S. R. Allen1, R. Cheney1, J. Ellis1, D. Holena1, J. Pascual1, N. Martin1, P. Kim1, P. Reilly1 1Hospital Of The University Of Pennsylvania,Trauma, Surgical Critical Care And Emergency Surgery,Philadelphia, PA, USA
Introduction: Falls are an important source of injury and mortality in the U.S. The impact of falls, especially in elderly marks the need to target fall prevention. Injury research and prevention strategies with alcohol use and motor vehicle crashes are well established, however.a paucity of data exists for alcohol as a risk factor in falls in elders. It is hypothesized that there is an intersection of both physical vulnerability (pre-existing co-morbidities (PEC)) and external risks (alcohol). We set out to identify this intersection of these factors across adult age groups and evaluate the clinical implications (morbidity and mortality) to identify opportunities for focused interventions.
Methods: The Trauma Registry at an urban Level 1 trauma center was queried for fall related injuries in patients 18 and older from July 2008 to June 2013. Patients were grouped into young (18-49 years) then by decade thereafter. Data included demographics, use of alcohol and blood alcohol concentration (BAC), number of PEC's, ISS, lengths of stay, complications, and mortality. P<0.05 was significant.
Results: 4130 patients were seen for falls during this period. 71.5% were tested for ETOH. Older patients had higher ISS than younger patients. More patients 60-69 (n= 385) had at >1 PEC than the young group (n=1031). A similar proportion of those 60-69 used alcohol at the time of the fall as the young, with similar BAC. Twice as many patients in 60-69 group suffered complications than the young. Mortality was higher in the 60-69 group. The increase in mortality was amplified among those in their 60’s who suffered a complication compared to the young (Table 1).
Conclusion: Sexagenarians who fall appear to use alcohol to a similar extent as young adults but have significantly more PEC’s. The intersection of significant alcohol consumption and physiologic vulnerability is marked by more serious injuries, more complications and higher mortality. Alcohol may be a modifiable risk factor in this overlooked age group who fall. Interventions focused on alcohol use may help to reduce falls among this group of elderly adults.
