Article

While the relevance of falls in raising the risk of fractures,
hospitalization and disability in older age is well recognized, the factors
influencing the onset of fractures and the need for ward admission after a fall
have yet to be fully elucidated. We investigated which factors and fall dynamics
were mainly associated with fall-related injuries and hospitalization among
elderly persons accessing the Emergency Department (ED) following a fall.
METHODS: The study involved 2144 older subjects who accessed the ED after a fall.
Data on the fall s nature and related injuries, ward admissions, history of
falls, dementia, and medical therapies were examined for all patients.
Considering dynamics, we distinguished accidental falls (due to interaction with
environmental hazards while in motion) and falls from standing (secondary to
syncope, lipothymia, drop attack, or vertigo). RESULTS: The overall prevalence of
fractures in our population did not differ significantly with advancing age,
though hip fractures were more common in the oldest, and upper limb fractures in
the youngest patients. Falls from standing were associated with polypharmacy and
with higher ward admission rate despite a lower fractures prevalence than
accidental falls. The chances of fall-related fractures were more than fourfold
as high for accidental dynamics (OR=4.05, 95%CI:3.10-5.29, p<0.0001). Ward
admission was associated with polypharmacy, dementia, anticoagulants use and
fall-related fractures (OR=6.84, 95%CI:5.45-8.58, p<0.0001), while it correlated
inversely with accidental fall dynamics. CONCLUSIONS: Outcomes of falls in older
age depend not only on any fall-related injuries, but also on factors such as
polypharmacy, cognitive status and fall dynamics.
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Langue : ANGLAIS