Emergency department visits for fall-related fractures among older adults in the USA: A Retrospective cross-sectional analysis of the National Electronic Injury Surveillance System All Injury Program, 2001-2008

Abstract

Objectives: To describe the demographic characteristics and incidence of unintentional fallrelated fractures among older adults treated in the US hospital emergency departments (EDs). Design: Retrospective observational study. Settings: Hospitals' ED participants in the National Electronic Injury Surveillance System All Injury Program (NEISS-AIP). Participants: The NEISS-AIP was used to generate national estimates of hospital ED visits for unintentional fall-related fracture among adults aged 65 years or older between 2001 and 2008. Census population estimates were used as the denominator to calculate age-specific and age-adjusted fracture rates per 100 000 persons. Main outcome measures: Fall-related fracture rates and ED disposition. Results: On the basis of 70 199 cases, an estimated 4.05 million older adults were treated in US hospital EDs for fall-related fracture during the 8-year period. Twothirds of the injuries occurred at home and 69.5% (95% CI 59.7% to 77.8%) of the affected individuals were white. Fall-related fracture rates increased gradually with age and were on average twofold higher among women. Of those hospitalised, women and fractures of the lower trunk represented 75.2% and 65.1% of the admissions, respectively. The estimated number of fall-related fractures treated in EDs increased from 574 500 in 2001 to 714 800 in 2008, a 24.4% increase. By gender, a nonsignificant upward trend in age-adjusted fall-related fracture rates was predominantly seen among men at an annual rate of 1.9% (95% CI -0.1% to 4.0%), whereas fracture rates among women remained stable at 0.9% (95% CI -0.7% to 2.5%) per year. Conclusions: The oldest old, women and lower trunk fractures account for the majority of fall-related fractures among persons aged 65 years or older treated in US hospital EDs. Increasing ED visits and hospitalisations for fall-related fracture among older adults deserve further research.