FALL-RELATED DEATH
Unintentional falls are a threat to the lives, independence and health of adult’s ages 65 and older. According to the Centers for Disease Control and Prevention, every 18 seconds, an older adult is treated in an emergency department for a fall, and every 35 minutes someone in this population dies as a result of their injuries.
More than one third of adults 65 and older fall each year in the United States (Hornbrook et al. 1994; Hausdorff et al. 2001). Among older adults, falls are the leading cause of injury deaths. They are also the most common cause of nonfatal injuries and hospital admissions for trauma (CDC 2006).
Case Studies – Ada County Coroner’s Office
Case 1. Blunt Force Trauma to the Head - due to falling down stairs
In October, 2006, an Ada County Deputy Coroner responded to a local hospital to investigate the death of an elderly male that had died due to a fall down a flight of stairs at his residence. According to interviews with next-of-kin, the decedent had been carrying a basket of clothes up the basement stairs when he lost his balance and fell backwards – falling down five or six stairs and striking his head. He was taken to a local hospital by EMS where a CAT scan was performed that showed a Basilar Skull Fracture with both Subarachnoid and Subdural Hemorrhages. The patient was transported by Lifeflight to a Boise hospital for further treatment. Family members and the patient’s physician consulted – with the severity of the injuries and his age, the prognosis for recovery was very grave. Family members made the decision to provide comfort measures only and the patient died within hours of the decision.
Case 2. Blunt Force Trauma to the Head – due to slip and fall on ice
February, 2006, an Ada County Deputy Coroner responded to a local hospital where, according to information received from witnesses and medical records, a 78 year-old male patient was walking to the front door of a medical clinic in Eastern Oregon for a scheduled appointment, when in some manner slipped on ice on the sidewalk and struck his head on the building. He fell to the ground – a family member rushed to his aid. She was unable to assist him back to his feet. She then went into the clinic and tried to get help from someone. No aid was present at that time. She then went back out to the man and helped him to his feet. The two then entered the medical clinic and informed the staff what had happened. The subject was then taken in to an exam room for his appointment. After a few minutes, the nurse informed the family that the patient was complaining of a headache and that his eyes hurt. At that time swelling of the injury above the subjects right eye had grown quite large. The family member then took the him to a local hospital for emergent care.
Upon admission he was diagnosed with a right frontal parietal subdural hematoma, intracranial bleed, concussion, and minor abrasion to right shoulder. Due to the severity of his condition, Lifeflight was contacted and the subject was air lifted to a Boise hospital for an emergency craniotomy. The evacuation was performed without complications, but due to the severity of his condition his prognosis was poor and he was placed on comfort care – expiring soon after.
Traumatic Brain Injury
Among older adults, both unintentional falls and traumatic brain injuries (TBI) result in significant morbidity and mortality; however, only limited national data on fall-related TBI are available. Method: To examine the relationship between older adult falls and TBI deaths and hospitalizations, CDC analyzed 2005 data from the National Center for Health Statistics' National Vital Statistics System and the Agency for Healthcare Research and Quality's Nationwide Inpatient Sample. Results: In 2005, among adults ≥ 65 years, there were 7946 fall-related TBI deaths and an estimated 56,423 hospitalizations for nonfatal fall-related TBI in the United States. Fall-related TBI accounted for 50.3% of unintentional fall deaths and 8.0% of nonfatal fall-related hospitalizations. Summary: These findings underscore the need for greater dissemination and implementation of evidence-based fall prevention interventions.
Falls are the second leading cause of unintentional-injury deaths in the United States for persons of all ages. (Motor-vehicle crashes continue to be the leading cause of such deaths.) For people age 79 and older, falls are the leading cause of unintentional-injury deaths. More than 14,000 people died from falls in 1996 - two-thirds of them age 75 years or older.
Nonfatal injuries from falls are also quite numerous. Close to 22 million medical visits were made because of such injuries during 1996. About 7,210,000 people were seen in hospital emergency departments for fall-related injuries; another 792,000 visits to outpatient departments were due to falls and there were about 14,662,000 physician's office visits because of fall-related injuries in 1996.
Even though falls are a prominent safety problem, there is some good news. Both the number of fall-related deaths and the death rate per 100,000 populations has shown significant improvement over the last 50 years - in spite of growth in the elderly population. On the other hand, there is some cause for concern in that deaths and death rates have risen slightly in the last few years.
FALL-RELATED DEATH
Unintentional falls are a threat to the lives, independence and health of adult’s ages 65 and older. According to the Centers for Disease Control and Prevention, every 18 seconds, an older adult is treated in an emergency department for a fall, and every 35 minutes someone in this population dies as a result of their injuries.
More than one third of adults 65 and older fall each year in the United States (Hornbrook et al. 1994; Hausdorff et al. 2001). Among older adults, falls are the leading cause of injury deaths. They are also the most common cause of nonfatal injuries and hospital admissions for trauma (CDC 2006).
Case Studies – Ada County Coroner’s Office
Case 1. Blunt Force Trauma to the Head - due to falling down stairs
In October, 2006, an Ada County Deputy Coroner responded to a local hospital to investigate the death of an elderly male that had died due to a fall down a flight of stairs at his residence. According to interviews with next-of-kin, the decedent had been carrying a basket of clothes up the basement stairs when he lost his balance and fell backwards – falling down five or six stairs and striking his head. He was taken to a local hospital by EMS where a CAT scan was performed that showed a Basilar Skull Fracture with both Subarachnoid and Subdural Hemorrhages. The patient was transported by Lifeflight to a Boise hospital for further treatment. Family members and the patient’s physician consulted – with the severity of the injuries and his age, the prognosis for recovery was very grave. Family members made the decision to provide comfort measures only and the patient died within hours of the decision.
Case 2. Blunt Force Trauma to the Head – due to slip and fall on ice
February, 2006, an Ada County Deputy Coroner responded to a local hospital where, according to information received from witnesses and medical records, a 78 year-old male patient was walking to the front door of a medical clinic in Eastern Oregon for a scheduled appointment, when in some manner slipped on ice on the sidewalk and struck his head on the building. He fell to the ground – a family member rushed to his aid. She was unable to assist him back to his feet. She then went into the clinic and tried to get help from someone. No aid was present at that time. She then went back out to the man and helped him to his feet. The two then entered the medical clinic and informed the staff what had happened. The subject was then taken in to an exam room for his appointment. After a few minutes, the nurse informed the family that the patient was complaining of a headache and that his eyes hurt. At that time swelling of the injury above the subjects right eye had grown quite large. The family member then took the him to a local hospital for emergent care.
Upon admission he was diagnosed with a right frontal parietal subdural hematoma, intracranial bleed, concussion, and minor abrasion to right shoulder. Due to the severity of his condition, Lifeflight was contacted and the subject was air lifted to a Boise hospital for an emergency craniotomy. The evacuation was performed without complications, but due to the severity of his condition his prognosis was poor and he was placed on comfort care – expiring soon after.
Traumatic Brain Injury
Among older adults, both unintentional falls and traumatic brain injuries (TBI) result in significant morbidity and mortality; however, only limited national data on fall-related TBI are available. Method: To examine the relationship between older adult falls and TBI deaths and hospitalizations, CDC analyzed 2005 data from the National Center for Health Statistics' National Vital Statistics System and the Agency for Healthcare Research and Quality's Nationwide Inpatient Sample. Results: In 2005, among adults ≥ 65 years, there were 7946 fall-related TBI deaths and an estimated 56,423 hospitalizations for nonfatal fall-related TBI in the United States. Fall-related TBI accounted for 50.3% of unintentional fall deaths and 8.0% of nonfatal fall-related hospitalizations. Summary: These findings underscore the need for greater dissemination and implementation of evidence-based fall prevention interventions.
Falls are the second leading cause of unintentional-injury deaths in the United States for persons of all ages. (Motor-vehicle crashes continue to be the leading cause of such deaths.) For people age 79 and older, falls are the leading cause of unintentional-injury deaths. More than 14,000 people died from falls in 1996 - two-thirds of them age 75 years or older.
Nonfatal injuries from falls are also quite numerous. Close to 22 million medical visits were made because of such injuries during 1996. About 7,210,000 people were seen in hospital emergency departments for fall-related injuries; another 792,000 visits to outpatient departments were due to falls and there were about 14,662,000 physician's office visits because of fall-related injuries in 1996.
Even though falls are a prominent safety problem, there is some good news. Both the number of fall-related deaths and the death rate per 100,000 populations has shown significant improvement over the last 50 years - in spite of growth in the elderly population. On the other hand, there is some cause for concern in that deaths and death rates have risen slightly in the last few years.