Midwest Surgical Association
Health care and socioeconomic impact of falls in the elderly

https://doi.org/10.1016/j.amjsurg.2011.09.018Get rights and content

Abstract

Background

Elderly falls are associated with long hospital stays, major morbidity, and mortality. We sought to examine the fate of patients ≥75 years of age admitted after falls.

Methods

We reviewed all fall admissions in 2008. Causes, comorbidities, injuries, procedures, mortality, readmission, and costs were analyzed.

Results

Seven hundred eight patients ≥75 years old were admitted after a fall, with 89% being simple falls. Short-term mortality was 6%. Male sex, atrial fibrillation, acute myocardial infarction, congestive heart failure (CHF), intracranial hemorrhage, hospital-acquired pneumonia, trigger events, Clostridium difficile, and intubation were predictors of death (P < .05). Thirty-day readmission occurred in 14%; CHF, craniotomy, and acute renal failure were predictive. The median cost of hospitalization was $11,000 with cardiac disease, anemia, major orthopedic and neurosurgical procedures, pneumonia, and intubation as predictive.

Conclusions

Simple falls in the elderly have high morbidity, mortality, and costs. Methodologies for prevention are warranted and should be studied intensively.

Section snippets

Methods

We retrospectively reviewed all admissions after falls in the 2008 calendar year for patients ≥75 years of age. We chose 75 as the age cutoff to reflect an older population to better assess the impact of falls on a frail elderly population with many comorbidities. The endpoints were mortality, 30-day readmission, and hospital costs for the index admission. Sex, age, and the type of fall were analyzed. Comorbidities considered were dementia, body mass index, coronary artery disease, acute

Results

In 2008, there were 708 patients 75 years of age and older who were admitted after a fall. The average length of stay was 5 days, with 4 days being the median. Males comprised one third of the patients and the average age was 85 years. Most events (89%) were simple falls from standing. Most patients (69%) were discharged to rehabilitation or extended-care facilities. Only 25% were discharged home and 76% of those required home health services. Functional activity was decreased in 19% of

Comments

Simple falls from standing in the elderly have a high morbidity and mortality and contribute significantly to health care costs. Our 30-day in-house mortality in this elderly trauma cohort was 6%, with those having cardiac comorbidities being at the highest risk. Atrial fibrillation was an independent risk factor by multivariate analysis, whereas anticoagulation was not, which is consistent with our previous published data from the same period showing that at our institution there no increase

References (12)

There are more references available in the full text version of this article.

Cited by (0)

View full text