First Fall-Related Injuries Requiring Hospitalization Increase the Risk of Recurrent Injurious Falls: A Nationwide Cohort Study in Taiwan

Recurrent falls not only have risk factors different from those of single falls but also have less favorable outcomes. The aim of our study was to determine the association between the injury characteristics of a first fall and the likelihood of recurrent injurious falls in a cohort of hospitalized...

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Bibliographic Details
Published in:PloS one 2016-02, Vol.11 (2), p.e0149887-e0149887
Main Authors: Lam, Carlos, Kang, Jiunn-Horng, Lin, Hsiao-Yu, Huang, Hung-Chang, Wu, Chia-Chieh, Chen, Ping-Ling
Format: Article
Language:English
Subjects:
Accidental falls
Accidental Falls - statistics & numerical data
Adults
Age
Aged
Aging
Ambulatory care
Biology and Life Sciences
Care and treatment
Cohort analysis
Cohort Studies
Comorbidity
Confidence intervals
Critical care
Demographics
Demography
Emergency medical care
Falls
Female
Hazards
Head injuries
Health insurance
Health risks
Hospitalization
Hospitalization - statistics & numerical data
Hospitals
Humans
Incidence
Injuries
Injury prevention
Male
Medicine
Medicine and Health Sciences
Middle Aged
Mortality
Older people
Patient outcomes
Patients
People and Places
Population
Public health
Recurrence
Rehabilitation
Risk analysis
Risk Factors
Risk groups
Spine
Statistical models
Studies
Taiwan - epidemiology
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Summary:Recurrent falls not only have risk factors different from those of single falls but also have less favorable outcomes. The aim of our study was to determine the association between the injury characteristics of a first fall and the likelihood of recurrent injurious falls in a cohort of hospitalized patients. We designed a nationwide retrospective cohort study and selected hospitalized patients who had injurious falls between 2001 and 2010. Cox proportional hazards models were used to estimate the hazard ratios (HRs) of recurrent injurious falls requiring hospitalization in the following year on the basis of the patients' demographic characteristics, comorbidities, and the characteristics of injuries from the first injurious fall requiring hospitalization. Among the 504 512 patients hospitalized for injurious falls, 19 442 experienced recurrent injurious falls requiring hospitalization. The 1-year incidence of recurrent injurious falls requiring hospitalization was 3.85%. The incidence density was the highest within the 3-month period after the first injurious fall. The risk of recurrent injurious falls among patients aged 40 to 64, 65 to 74, and ≥ 75 years increased progressively (HR: 2.11, 95% confidence interval [CI]: 1.90-2.34; HR: 2.80, 95% CI: 2.51-3.11; and HR: 3.80, 95% CI: 3.42-4.23, respectively). The length of hospitalization (LOH) ≥ 15 or ≥ 31 days (HR: 1.39, 95% CI: 1.30-1.48; and HR: 1.59, 95% CI: 1.43-1.77, respectively) and injury to the head (HR: 1.59, 95% CI: 1.53-1.65) or spine (HR: 1.66, 95% CI: 1.59-1.74) were also found to be major risk factors. Our findings show that the LOH and head and spine injuries are associated with an increased risk of recurrent injurious falls leading to hospitalization. The risk of recurrent injurious falls requiring hospitalization increased significantly among adults older than 40 years. We suggest further research on the effects of injury characteristics associated with the first injurious fall requiring hospitalization and resultant anatomical damages on the risk of recurrent injurious falls requiring hospitalization. High-risk patients should receive tailored rehabilitation addressing their respective injuries within 3 months after hospital discharge.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0149887