Hannah Wheeler, RN
Registered Nurse
Johnson City Medical Center, United States
Disclosure information not submitted.
Bracken Burns, DO, FACS, FACOS
Professor of Surgery
East Tennessee State University, United States
Disclosure information not submitted.
Title: Gender Disparity in Outcomes after Elderly Falls at a Rural Level 1 Trauma Center
Introduction/Hypothesis:Differences in patient outcomes by gender has been reported in common diseases and illnesses but little is known about gender differences in elderly patients after falls. The goal of this study was to observe gender disparities in relation to falls and injuries among adults age 60 years and older. We hypothesized that there will be no difference in gender related outcomes from falls.
Methods: A single institution, retrospective analysis was conducted at a Level I Trauma Center located in rural East Tennessee. The study received exemption from the East Tennessee State University Institutional Review Board (c0816.20e). Data was extracted from the Trauma Registry between January 2016 to December 2019. The study population included trauma patients ≥ 60 years of age who presented to the emergency room after experiencing a fall. The variables used in the data analysis included age, gender, type of fall, hospital days, intensive care unit (ICU) days, Injury Severity Score (ISS), disposition, mortality, hip fracture injury.
Results: 3,306 patients were observed in this retrospective study. There were 1127 males (average age 76 years) and 2179 females (average age 79 years). Men were more likely to have longer hospital days ( 5.3 days vs 4.8 days; p≤0.05), longer ICU days (0.9 days vs 0.4 days; p≤0.05), longer ventilator days (0.2 days vs 0.1 days; p≤0.05), higher ISS (8.3 vs 7.7; p≤0.05), and higher mortality (9% vs 3%; p≤0.05). However, women were more likely (p≤0.05) to suffer from a hip fracture and were more likely to be discharged (p≤0.05) to an acute care facility after hospital discharge. Falls were categorized based on type of fall. The most common type of fall for both men and women were GLFs from tripping, slipping, or stumbling. A sub-analysis was done for types of falls and it determined that men were statistically more like to experience a fall outside vs inside compared to women and men were statistically more like to experience a fall from height vs a ground level fall compared to women.
Conclusion: This study revealed that although women are more likely to experience a fall as well as hip fractures, men have poorer outcomes such as increased mortality. Knowledge surrounding falls is important in developing prevention strategies.