M. Khurrum1, K. Hanna1, M. Hamidi1, M. Chehab1, N. Kulvatunyou1, L. Gries1, S. Asmar1, B. Joseph1 1University of Arizona,Trauma Critical Care Burns And Emergency Surgery,TUCSON, ARIZONA, USA
Introduction: Ground level falls (GLF) are typically reported as a minor mechanism of injury, however, they represent a significant portion of hospitalized geriatric trauma patients as they can result in multisystem injury in this subset of the population. The aim of our study was to analyze trends in geriatric trauma falls on the national level.
Methods: We performed a 5-year (2010-2014) analysis of the American College of Surgeons National Trauma Data Bank (ACS-NTDB) and included all geriatric trauma patients (age >= 65 years) who presented with ground-level falls. Ground-level falls were selected using ICD-9 ECODES. Our outcome measures were national incidence GLF, overall discharge disposition, distribution among different trauma centers, and trauma centers level-specific discharge disposition. Cochran Armitage test for trends was used in our analysis.
Results: We analyzed a total of 925,482 geriatric trauma patients, of which 40% had had a fall as mechanism of injury. Among those who fell, the mean age was 77 +/- 7, 57.1% were females, and 85% were whites. The incidence of falls was significantly increasing over the study period and was noticed to be significantly proportional to age and plateaus around the age of 88 and higher Figure 1a, 1b. In terms of discharge disposition, the rate of SNF/Rehab disposition has been significantly increasing, however, discharge to home and mortality rate were down trending over the study period. Figure 1c. Regarding trauma centers, the majority of geriatric falls are being treated at Level 1 trauma centers followed by Level II, III and IV Figure 1d. Discharge to SNF and Rehab was significantly lower among level I trauma centers compared to other levels of trauma centers. On the other hand, discharge to home was higher in Level I trauma centers compared to other levels of trauma centers Figure 1e.
Conclusion: Around one in six elderly individuals is likely to be admitted following a GLF with an overall increasing incidence of falls over time. Although overall rates of mortality were decreasing, There is an increase in adverse discharge disposition and loss of functional independence mostly upon admission to non-level I trauma centers.
