Stacy A Drake1, Sadie H Conway2, Yijiong Yang3, Latarsha S Cheatham3, Dwayne A Wolf4, Sasha D Adams5,6, Charles E Wade5,6, John B Holcomb7. 1. Texas A&M University, College of Nursing, College Station, Texas, United States of America. 2. The University of Texas Health Science Center at Houston School of Public Health, Houston, Texas, United States of America. 3. The University of Texas Health Science Center at Houston, Cizik School of Nursing, Houston, Texas, United States of America. 4. Harris County Institute of Forensic Sciences, Houston, Texas, United States of America. 5. Center for Translational Injury Research, Houston, Texas, United States of America. 6. McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, Texas, United States of America. 7. Department of Surgery, University of Alabama, Birmingham, Alabama, United States of America.
Abstract
OBJECTIVES: This study encompassed fall-related deaths, including those who died prior to medical care, that were admitted to multiple healthcare institutions, regardless of whether they died at home, in long-term care, or in hospice. The common element was that all deaths resulted directly or indirectly from injuries sustained during a fall, regardless of the temporal relationship. This comprehensive approach provides an unusual illustration of the clinical sequence of fall-related deaths. Understanding this pathway lays the groundwork for identification of gaps in healthcare needs. DESIGN: This is a retrospective study of 2014 fall-related deaths recorded by one medical examiner's office (n = 511) within a larger dataset of all trauma related deaths (n = 1848). Decedent demographic characteristics and fall-related variables associated with the deaths were coded and described. RESULTS: Of those falling, 483 (94.5%) were from heights less than 10 feet and 394 (77.1%) were aged 65+. The largest proportion of deaths (n = 267, 52.3%) occurred post-discharge from an acute care setting. Of those who had a documented prior fall, 216 (42.3%) had a history of one fall while 31 (6.1%) had ≥2 falls prior to their fatal incident. For the 267 post-acute care deaths, 440 healthcare admissions were involved in their care. Of 267 deaths occurring post-acute care, 129 (48.3%) were readmitted within 30 days. Preventability, defined as opportunities for improvement in care that may have influenced the outcome, was assessed. Of the 1848 trauma deaths, 511 (27.7%) were due to falls of which 361 (70.6%) were determined to be preventable or potentially preventable. CONCLUSION: Our data show that readmissions and repeated falls are frequent events in the clinical sequence of fall fatalities. Efforts to prevent fall-related readmissions should be a top priority for improving fall outcomes and increasing the quality of life among those at risk of falling.
OBJECTIVES: This study encompassed fall-related deaths, including those who died prior to medical care, that were admitted to multiple healthcare institutions, regardless of whether they died at home, in long-term care, or in hospice. The common element was that all deaths resulted directly or indirectly from injuries sustained during a fall, regardless of the temporal relationship. This comprehensive approach provides an unusual illustration of the clinical sequence of fall-related deaths. Understanding this pathway lays the groundwork for identification of gaps in healthcare needs. DESIGN: This is a retrospective study of 2014 fall-related deaths recorded by one medical examiner's office (n = 511) within a larger dataset of all trauma related deaths (n = 1848). Decedent demographic characteristics and fall-related variables associated with the deaths were coded and described. RESULTS: Of those falling, 483 (94.5%) were from heights less than 10 feet and 394 (77.1%) were aged 65+. The largest proportion of deaths (n = 267, 52.3%) occurred post-discharge from an acute care setting. Of those who had a documented prior fall, 216 (42.3%) had a history of one fall while 31 (6.1%) had ≥2 falls prior to their fatal incident. For the 267 post-acute care deaths, 440 healthcare admissions were involved in their care. Of 267 deaths occurring post-acute care, 129 (48.3%) were readmitted within 30 days. Preventability, defined as opportunities for improvement in care that may have influenced the outcome, was assessed. Of the 1848 trauma deaths, 511 (27.7%) were due to falls of which 361 (70.6%) were determined to be preventable or potentially preventable. CONCLUSION: Our data show that readmissions and repeated falls are frequent events in the clinical sequence of fall fatalities. Efforts to prevent fall-related readmissions should be a top priority for improving fall outcomes and increasing the quality of life among those at risk of falling.
Authors: Rosemary A Kozar; Saman Arbabi; Deborah M Stein; Steven R Shackford; Robert D Barraco; Walter L Biffl; Karen J Brasel; Zara Cooper; Samir M Fakhry; David Livingston; Frederick Moore; Fred Luchette Journal: J Trauma Acute Care Surg Date: 2015-06 Impact factor: 3.313
Authors: Stacy A Drake; John B Holcomb; Yijiong Yang; Caitlin Thetford; Lauren Myers; Morgan Brock; Dwayne A Wolf; Stanley Cron; David Persse; James McCarthy; Lillian Kao; S Rob Todd; Bindi J Naik-Mathuria; Charles Cox; Ryan Kitagawa; Glenn Sandberg; Charles E Wade Journal: Ann Surg Date: 2020-02 Impact factor: 12.969
Authors: Stacy A Drake; Dwayne A Wolf; Janet C Meininger; Stanley G Cron; Thomas Reynold; Charles E Wade; John B Holcomb Journal: Trauma Surg Acute Care Open Date: 2017-05-31
Authors: Weronika Grabowska; Wren Burton; Matthew H Kowalski; Robert Vining; Cynthia R Long; Anthony Lisi; Jeffrey M Hausdorff; Brad Manor; Dennis Muñoz-Vergara; Peter M Wayne Journal: BMC Musculoskelet Disord Date: 2022-09-05 Impact factor: 2.562