Risks factors for significant injury after geriatric falls

Risks factors for significant injury after geriatric falls

Jon D. Dorfman MD1, Allison Wyman MS2, Gordon FitzGerald PhD2, Timothy A. Emhoff MD1, Fred A. Anderson PhD2, Heena P. Santry MD MS3
1Department of Surgery, University of Massachusetts Memorial Medical Center Worcester, MA;
2University of Massachusetts Medical School, Worcester, MA; 3Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH (formerly at 1,2)

international journal of aging research

Elderly falls are a healthcare epidemic. We aimed to identify risk factors of serious falls by linking data on functional status from the Global Longitudinal Study of Osteoporosis in Women (GLOW) and our institutional trauma registry. 124 of 5,091 local women enrolled in GLOW were evaluated by our trauma team for injuries related to a fall during the study period. Median injury severity score was 9. The most common injuries were intertrochanteric femur fracture (n = 25, 9.8%) and skin contusion/hematoma to face (n = 12, 4.7%). Injured women were older than the uninjured cohort (median 80 versus 68 years), more likely to have cardiovascular disease and osteoarthritis, and less likely to have high cholesterol. Prospectively collected Short Form 36 (SF-36) baseline activity status revealed greater limitation in all assessed activities in women evaluated for fall-related injuries in our trauma center. In multivariable analysis, age (per 10 year increase) and two or more self-reported falls in the baseline survey were the strongest predictors of falling (both HR 2.4, p <0.0001 and p<0.001 respectively), followed by history of osteoarthritis (HR 1.6, p= 0.01). Functional status was no longer associated with risk of fall when adjusting for these factors.
Functional status appears to be a surrogate marker for frailty. With the aging of the US population and long lifespan of American women, this finding has important implications for both fall prevention strategies and research intended to better understand why aging women fall as burdensome validated metrics may not be the best indicators of fall risk.

The authors have no conflict of interests to declare. Funding statement: This work was partially supported by grants from NIH (8KL2TR000160-03), AHRQ (R01HS22694), and PCORI (ME-1310-07682) to HS.

Keywords: geriatric, falls, trauma

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How to cite this article:
Jon D. Dorfman, Allison Wyman, Gordon FitzGerald, Timothy A. Emhoff, Fred A. Anderson, Heena P. Santry.Risks factors for significant injury after geriatric falls. International Journal of Aging Research, 2019, 2:27. DOI: 10.28933/ijoar-2018-12-2305


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