Correlates of Fall-Related Mortality in U. S. Elderly

Purpose: Fall mortality is rising among U.S. elderly. Understanding the associated risk factors is essential to addressing this rise. The study objectives included exploring the relationship between age, common fall injuries and inhospital death.

Methods: Elder adults who died from fall-related injuries were identified through hospital discharge records in the 2005 Health Cost Utilization Project (HCUP) Nationwide Inpatient Sample (NIS). Health and socioeconomic status indicators significantly associated with death were modeled using logistic regression analysis.

Results: After controlling for covariates (such as health status) increased age was associated with an increased odds of death (75-84 OR 1.22; 85-94 OR 1.70; 95 and older OR 2.59). Out of fractures only intracranial fracture (OR 4.42) resulted in higher odds of death. Being female (OR 0.59), Hispanic (OR 0.70) and cognitively impaired (OR 0.61) lowered the risk of death compared to being male, white and cognitively intact.

Conclusions: Increased age at admission was significantly associated with increased risk of fall death. This relationship remained unchanged after controlling for sociodemographic and health status indicators and questions the concept that age as a risk factor is due to increasing disease burden from increasing years of life. This study found men more likely to die from falls than women. The cognitively impaired were less likely to die from falls than the cognitively intact. These findings highlight the need for refinement of falls prevention programs and consideration of whether risk factors associated with fall deaths are different from the risk factors for falling and fall-related injuries.