First fall-related injuries requiring hospitalization increase the risk of recurrent injurious falls

A nationwide cohort study in Taiwan

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6 Citations (Scopus)

Abstract

Objectives. 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. Methods. 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. Results. 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. Conclusions. 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.

Original languageEnglish
Article numbere0149887
JournalPLoS One
Volume11
Issue number2
DOIs
Publication statusPublished - Feb 1 2016

Fingerprint

cohort studies
Taiwan
confidence interval
Hazards
Hospitalization
Cohort Studies
Wounds and Injuries
Confidence Intervals
risk factors
Craniocerebral Trauma
incidence
sociodemographic characteristics
Spine
Incidence
Patient rehabilitation
Proportional Hazards Models
Comorbidity
Rehabilitation
Retrospective Studies
Demography

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

Cite this

@article{8ad0159c9bd84433904e1cba467f906e,
title = "First fall-related injuries requiring hospitalization increase the risk of recurrent injurious falls: A nationwide cohort study in Taiwan",
abstract = "Objectives. 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. Methods. 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. Results. 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. Conclusions. 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.",
author = "Carlos Lam and Kang, {Jiunn Horng} and Lin, {Hsiao Yu} and Huang, {Hung Chang} and Wu, {Chia Chieh} and Chen, {Ping Ling}",
year = "2016",
month = "2",
day = "1",
doi = "10.1371/journal.pone.0149887",
language = "English",
volume = "11",
journal = "PLoS One",
issn = "1932-6203",
publisher = "Public Library of Science",
number = "2",

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TY - JOUR

T1 - First fall-related injuries requiring hospitalization increase the risk of recurrent injurious falls

T2 - A nationwide cohort study in Taiwan

AU - Lam, Carlos

AU - Kang, Jiunn Horng

AU - Lin, Hsiao Yu

AU - Huang, Hung Chang

AU - Wu, Chia Chieh

AU - Chen, Ping Ling

PY - 2016/2/1

Y1 - 2016/2/1

N2 - Objectives. 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. Methods. 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. Results. 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. Conclusions. 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.

AB - Objectives. 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. Methods. 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. Results. 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. Conclusions. 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.

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