Injuries from falls by older adults in long-term care captured on video: Prevalence of impacts and injuries to body parts

Abstract

Background Falls are the leading cause of injuries in older adults. However, most falls in older adults do not cause serious injury, suggesting that older adults may fall in a manner that reduces the likelihood of impact to body sites that are most vulnerable to injury. In this observational study of falls in long-term care (LTC), we tested whether body parts differed in their probability of impact and injury. Methods We recorded and analyzed videos of 2388 falls by 658 LTC residents (mean age 84.0 (SD = 8.1); 56.4% female). We used Linear Mixed Models to test for differences between body parts in the probability of impact and injury, and injury when impacts occurred. Results Injuries were reported in 38.2% of falls, and 85.9% of injuries involved direct impact to the injured body part. Impact occurred most often to the hip/pelvis (probability (standard error) = 0.95 (0.01); p < .001 relative to other body parts), and least often to the head (0.35 (0.01)). Conversely, injury occurred most often to the head (p < .001 relative to other body parts). The probability of injury when impacts occurred was 0.40 (0.01) for the head, and 0.11 or less for all other body parts. Conclusion Our results help to explain why most falls by older adults in LTC do not cause serious injury: residents land on body parts that are the most resilient to injury. The high susceptibility of the head to injury reinforces the need to enhance upper limb protective responses for fall arrest. The dominant role of direct impact as the mechanism of injury supports approaches to attenuate impact forces through strategies like protective clothing and compliant flooring.

Stair-related falls in the USA: traumatic brain injury and the role of alcohol intoxication

“…After reviewing the narrative text entries, it became apparent that very few alcohol-related falls on stairs occurred under the age of 15. Given the potential exacerbation of mobility limitations, balance issues and prescription drug interactions, we did not examine injuries among persons aged 65 and older as it would be difficult to fully understand the contribution of alcohol 7. Inter-rater reliability for coding open-ended narrative text ensued as follows.…”

“…Falls on staircases contribute significantly to the burden of fall-related injuries, with an annual estimate in excess of 1 million emergency department (ED visits annually in the USA 6. While much of the focus on staircase fall injuries has been on the older adult population,7–9 a few studies have examined younger populations and the role of alcohol use 10–15. Alcohol has been found to be associated with TBI among persons who were injured falling on stairs 10 12 14 15.…”

Falls From Beds Among Elderly Outpatients: Injuries and Outcomes

“…Approximately 1% of all elderly falls result in hip fractures, which significantly increase the risk of morbidity and mortality post-fall [ 4 ]. Furthermore, a study conducted in 2022 over a nine-year period involving 658 residents in a long-term care facility found that falls accounted for over 90% of hip fractures and up to 80% of traumatic brain injuries (TBIs) in older adults [ 5 ]. This review seeks to consolidate and encapsulate the latest insights regarding falls that occur in bed among the elderly.…”

Mortality Trends due to Falls in the Group of People in Early (65–74 Years) and Late (75+) Old Age in Poland in the Years 2000–2020

“…They are the most common reason for hip fracture hospital admissions (9 in 10 cases). Other injuries that result from falls include head injuries, wrist fractures, humerus, intracranial hematomas, and injuries to internal organs [ 17 ]. In the group of people aged 75 and older, 70% of falls are fatal.…”