Trauma-related falls in an urban geriatric population: predictive risk factors for poorer clinical outcomes

Injury Epidemiology

Original Contribution

Taylor Castro¹  Shreya Nalubola²  Nisha Lakhi³  Alexander Farrell⁴ 

[1] College of Osteopathic Medicine, New York Institute of Technology, Old Westbury, NY, USA;School of Medicine, New York Medical College, Valhalla, NY, USA;School of Medicine, New York Medical College, Valhalla, NY, USA;Department of Trauma Surgery, Richmond University Medical Center, Staten Island, NY, USA;Touro University College of Osteopathic Medicine, Middletown, NY, USA;

关键词: Elderly;    Falls;    Polypharmacy;    Risk factors;    Adverse outcome;    Trauma;   

DOI  :  10.1186/s40621-023-00418-9

 received in 2022-09-23, accepted in 2023-01-19,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundThe aim of this study was to elucidate associations between polypharmacy, types of medications, and geriatric comorbidities to identify predictive risk factors for poorer clinical outcomes following trauma-related falls in the geriatric population. Nearly 80% of trauma-related hospital admissions in the older adult population are secondary to falls, accounting for 3 million emergency department visits annually. Numerous studies have demonstrated associations between falls, polypharmacy, and other geriatric comorbidities, but studies outlining predictive risk factors for poor clinical outcomes are lacking.MethodsA retrospective cohort study of 1087 patients ≥ 65 years old who presented to Level 1 Trauma Center after a trauma-related fall. Comorbidities, current medication, demographic information, and clinical outcomes were identified to ascertain predictive risk factors for poorer clinical outcomes. Variables were assessed for statistical significance on unadjusted analysis. Variables found to be significant were entered into a multivariable logistic regression model to test for adjusted associations, with p < 0.05 as statistically significant, and presented as adjusted odds ratios with 95% confidence intervals.ResultsPolypharmacy ≥ 4 medications (aOR 2.38 (1.10–5.15), p < .028) was an independent predictor of hospital readmission within 30 days. Chronic kidney disease, male gender, and Asian race had an increased association with ICU admission. History of malignancy (aOR 3.65 (1.62–8.19), p < .002) and chronic kidney disease (aOR 2.56 (1.11–5.96), p < .027) were independent predictors of 30-day mortality.ConclusionsPolypharmacy, chronic renal disease, malignancy history, male gender, and Asian race had an increased association of adverse clinical outcomes after falls in the geriatric population. Critical evaluation of patients with these risk factors may be needed to mitigate risk in this population.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

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