Falls in older people: comparing older and younger fallers in a developing country

Abstract

PurposeWhile falls are common in older people, causing significant mortality and morbidity, this phenomenon has not been extensively studied in the Caribbean. This study aimed to compare falls in older and younger people in this setting.MethodsWe conducted a prospective observational study of older trauma patients in Trinidad, comparing older and younger patients sustaining falls.Results1432 adult trauma patients were included (1141 aged 18–64 years and 291 aged 65 years and older). Older fallers were more likely to be female (66.7 vs 47.2%; p < 0.001), suffer from multiple pre-existing diseases (24.7 vs 2.4%; p < 0.001) and take multiple medications (16.1 vs 0.8%; p < 0.001). They also sustained more severe injuries and presented with higher acuity than younger fallers. Admission rates were higher among older fallers (29.9 vs 13.1%; p < 0.001).ConclusionsIn our study, older patients who fell were a distinct group from younger falls victims, with unique demographic, clinical and injury related characteristics. Their increased risk of injury within the home, coupled with their propensity for more severe injuries made them a high risk patient group. More research is needed to better understand this patient group and plan specific preventive interventions.Electronic supplementary materialThe online version of this article (doi:10.1007/s00068-017-0818-2) contains supplementary material, which is available to authorized users.

Factores asociados a caídas en adultos mayores chilenos: evidencia de la Encuesta Nacional de Salud 2009-2010

“…Nuestros resultados identifican que la mayor probabilidad de presentar caídas en un año, se asocia con el sexo femenino, situación coincidente a lo reportado por diversas investigaciones realizadas a nivel global [28][29][30][31][32] y nacional 7,33 . Manrique et al encontraron que en las mujeres, ciertos factores biológicos que predeterminan una disminución de su masa muscular, las haría más propensas a presentar caídas, pero también estaría supeditado a una mayor presencia de problemas de salud y longevidad 34 .…”

Registry-Based Mortality Analysis Reveals a High Proportion of Patient Decrees and Presumed Limitation of Therapy in Severe Geriatric Trauma

“…The median ISS and mortality risk (RISC II) of the cohort was high. The leading causes of accident in our cohort (falls and traffic accidents) correspond to the available epidemiological data on severe multiple trauma [ 2 , 29 , 30 ]. The large proportion of falls from a height of less than 3 m is notable.…”

“…Contrary to the preclinical assumption of a traumatic cause of the admission, in 25 patients (18.6%), an internal cause (e.g., syncopal fall from a standing position) was the cause of the hospitalization and death. (20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38) points, p = 0.382). The median (IQR) NISS was 36 (24-57) points.…”

Factors affecting mortality in major trauma patients in Trinidad and Tobago – A view from the developing world

“…The proportion of women and patients aged 65 years is low compared to studies from other countries, 20,21 but these proportions are in keeping with other studies done in Trinidad previously, suggesting that the proportion of women and patients aged 65 years who suffer major trauma in Trinidad is low. 13,16,17 Similarly, only inpatient mortality could be reliably determined for the purposes of this study, and the results therefore do not reflect longer term outcomes.…”

“…15 Several authors have investigated the outcomes and care of trauma patients in Trinidad; Naraynsingh et al compared trauma patterns and outcomes in older versus younger patients, over a one-month period, while Yogi et al specifically compared falls in older and younger people. 16,17 These studies investigated the epidemiology of trauma, but not the predictive value of trauma scoring systems and both were undertaken over limited time periods. Likewise, Hariharan et al's study which investigated the utility of the TRISS methodology in predicting outcomes for trauma patients in Trinidad, 13 collected data over only two months and included all injury severities.…”