alexa Why Elderly Patients with Ground Level Falls Die Within
ISSN: 2167-7182

Journal of Gerontology & Geriatric Research
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Research Article

Why Elderly Patients with Ground Level Falls Die Within 30 Days And Beyond?

Alicia Mangram1*, James Dzandu1, Gervork Harootunian2, Nicholas Zhou2, Jacqueline Sohn2, Michael Corneille3, Patrick O Neill4, Scott Petersen3,5, Olakunle F Oguntodu6 and William G Johnson7
1Honor Health John C. Lincoln Medical Center, USA
2Midwestern University Arizona, College of Osteopathic Medicine, USA
3Medical Center Hospital, USA
4Maricopa Integrated Health Systems, USA
5St Joseph’s Hospital, USA
6Valley Surgical Clinics, USA
7Arizona State University, USA
*Corresponding Author : Alicia Mangram
250 E. Dunlap Avenue, Phoenix AZ 85020
Honor Health John C. Lincoln Medical Center, USA
Tel: 602-633-3721
Fax: 602-995-3795
E-mail: [email protected]
Rec date: Jan 05, 2016 ; Acc date: Apr 05, 2016; Pub date: Apr 07, 2016
Citation:Mangram A, Dzandu J, Harootunian G, Zhou N, Sohn J, et al. (2016) Why Elderly Patients with Ground Level Falls Die Within 30 Days And Beyond?. J Gerontol Geriatr Res 5:289. doi:10.4172/2167-7182.1000289
Copyright: © 2016 Mangram A, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Background: Together with a growing geriatric population in the United States, ground level falls (GLF) are troubling and quickly becoming a significant cause for geriatric trauma deaths. This study describes the factors associated with GLF fall deaths and examines how these factors changed mortality rate over a 3-year follow-up. Methods: A retrospective study was conducted based on the ASU Center of Health Information and Research (CHiR) database. The dataset included 52,391 patients with GLF admissions at 4 Level-I trauma centers in Arizona from 2008-2011. Patients were identified using ICD-9 GLF specific E-codes E885.x to E888.x. 49,138 patients <60 years who had non-ground level falls were excluded. Abstracted patient demographics, injury characteristics, cause and post injury time of death were summarized and compared using non-parametric tests, Student’s t-test, ANOVA, univariate and multivariate regression methods as appropriate; p≤.05 was considered statistically significant. Results: There were 3,251 patients with GLF who were followed during the 3-year study period. The majority was white (85.7%), female (57.8%), and 36.1% were in the 8th decade of life. Most patients fell at home (71.5%) and suffered medium severity injuries (median ISS= 9). The Trauma Revised Injury Severity Score (TRISS) was 0.93 and mean Charlson Comorbidity Index (CCI) was 0.63. The mortality rate (31.1%) over the 3-year period was remarkably high despite the fact that GLF is often considered a low-energy mechanism of injury. We identified the following significant, non-modifiable and independent risk factors for 1-30 day post-injury mortality: age ≥80 years, male gender, ISS≥16, AIS head ≥4, AIS extremities >2, TRISS <0.63, CCI ≥0.67, and ICU LOS >2. Conclusion: GLF although considered a low-energy mechanism of injury, is fast becoming a significant cause of mortality among the elderly, beginning immediately after the injury, through intermediate and longer-term follow-up periods. Mortality outcomes were modified only by the unalterable effects of chronic conditions such as cardiac diseases, stroke, cancer, diabetes or liver diseases in subsequent years. We recommend trauma level 1 activation for all elderly patients who suffer GLF with concerns for head injury and emphasis on aggressive head injury management strategies to mitigate GLF-related deaths.

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