Risk factors for traumatic brain injuries during falls in older persons

Hei Fen Hwang, Chui Hsuan Cheng, Ding Kuo Chien, Wen Yu Yu, Mau Roung Lin

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Objective: To identify risk factors for traumatic brain injuries (TBIs) during falls in older Taiwanese people. Participants: Case patients consisted of 113 patients aged 60 years or older with a moderate/severe TBI due to a fall. Two control groups: (1) 339 older patients with a soft-Tissue injury; and (2) 113 with a mild-TBI due to a fall. Proxies were required to provide information for a considerable number of patients. Design: Matched case-control study. Settings: The emergency departments of 3 general hospitals. Measures: Sociodemographic, lifestyle behavior, chronic condition, medication use, functional abilities, and fall-related characteristics. Results: When patients with a soft-Tissue injury were assigned to the control group, men were 2.06-fold more likely to have a moderate/severe TBI than women. Subjects who took antiarrhythmics within 4 hours of a fall were 2.59-fold more likely to have a moderate/severe TBI than those who took none. Subjects who were negotiating stairs and getting in/out of the bed/chair were 3.12-fold and 2.97-fold, respectively, more likely to have a moderate/severe TBI than those who fell while walking. Falling backward and sideways was 4.07-fold and 2.30-fold, respectively, more likely to cause a moderate/severe TBI than falling forward. When patients with a mild-TBI were assigned to the control group, results were similar, with the exception that the effect of antiarrhythmic use became nonsignificant and subjects who took 2 or more medications were 3.07-fold more likely to have a moderate/severe TBI than those who took none. Conclusion: Avoiding a head impact during a backward or sideways fall, reducing unnecessary use of polypharmacy and antiarrhythmics, and maintaining safety during stair negotiation and bed/chair transfer may protect an elderly person from a severe brain injury.

Original languageEnglish
Pages (from-to)E9-E17
JournalJournal of Head Trauma Rehabilitation
Volume30
Issue number6
DOIs
Publication statusPublished - Nov 3 2015

Fingerprint

Accidental Falls
Brain Concussion
Soft Tissue Injuries
Negotiating
Control Groups
Polypharmacy
Aptitude
Proxy
Traumatic Brain Injury
General Hospitals
Brain Injuries
Walking
Case-Control Studies
Life Style
Hospital Emergency Service
Head
Safety

Keywords

  • fall mechanism
  • falls
  • older people
  • risk factor
  • traumatic brain injury

ASJC Scopus subject areas

  • Rehabilitation
  • Clinical Neurology
  • Physical Therapy, Sports Therapy and Rehabilitation

Cite this

Risk factors for traumatic brain injuries during falls in older persons. / Hwang, Hei Fen; Cheng, Chui Hsuan; Chien, Ding Kuo; Yu, Wen Yu; Lin, Mau Roung.

In: Journal of Head Trauma Rehabilitation, Vol. 30, No. 6, 03.11.2015, p. E9-E17.

Research output: Contribution to journalArticle

Hwang, Hei Fen ; Cheng, Chui Hsuan ; Chien, Ding Kuo ; Yu, Wen Yu ; Lin, Mau Roung. / Risk factors for traumatic brain injuries during falls in older persons. In: Journal of Head Trauma Rehabilitation. 2015 ; Vol. 30, No. 6. pp. E9-E17.
@article{bc4e82d329f84f288cc6d422fcb70ec7,
title = "Risk factors for traumatic brain injuries during falls in older persons",
abstract = "Objective: To identify risk factors for traumatic brain injuries (TBIs) during falls in older Taiwanese people. Participants: Case patients consisted of 113 patients aged 60 years or older with a moderate/severe TBI due to a fall. Two control groups: (1) 339 older patients with a soft-Tissue injury; and (2) 113 with a mild-TBI due to a fall. Proxies were required to provide information for a considerable number of patients. Design: Matched case-control study. Settings: The emergency departments of 3 general hospitals. Measures: Sociodemographic, lifestyle behavior, chronic condition, medication use, functional abilities, and fall-related characteristics. Results: When patients with a soft-Tissue injury were assigned to the control group, men were 2.06-fold more likely to have a moderate/severe TBI than women. Subjects who took antiarrhythmics within 4 hours of a fall were 2.59-fold more likely to have a moderate/severe TBI than those who took none. Subjects who were negotiating stairs and getting in/out of the bed/chair were 3.12-fold and 2.97-fold, respectively, more likely to have a moderate/severe TBI than those who fell while walking. Falling backward and sideways was 4.07-fold and 2.30-fold, respectively, more likely to cause a moderate/severe TBI than falling forward. When patients with a mild-TBI were assigned to the control group, results were similar, with the exception that the effect of antiarrhythmic use became nonsignificant and subjects who took 2 or more medications were 3.07-fold more likely to have a moderate/severe TBI than those who took none. Conclusion: Avoiding a head impact during a backward or sideways fall, reducing unnecessary use of polypharmacy and antiarrhythmics, and maintaining safety during stair negotiation and bed/chair transfer may protect an elderly person from a severe brain injury.",
keywords = "fall mechanism, falls, older people, risk factor, traumatic brain injury",
author = "Hwang, {Hei Fen} and Cheng, {Chui Hsuan} and Chien, {Ding Kuo} and Yu, {Wen Yu} and Lin, {Mau Roung}",
year = "2015",
month = "11",
day = "3",
doi = "10.1097/HTR.0000000000000093",
language = "English",
volume = "30",
pages = "E9--E17",
journal = "Journal of Head Trauma Rehabilitation",
issn = "0885-9701",
publisher = "Lippincott Williams and Wilkins",
number = "6",

}

TY - JOUR

T1 - Risk factors for traumatic brain injuries during falls in older persons

AU - Hwang, Hei Fen

AU - Cheng, Chui Hsuan

AU - Chien, Ding Kuo

AU - Yu, Wen Yu

AU - Lin, Mau Roung

PY - 2015/11/3

Y1 - 2015/11/3

N2 - Objective: To identify risk factors for traumatic brain injuries (TBIs) during falls in older Taiwanese people. Participants: Case patients consisted of 113 patients aged 60 years or older with a moderate/severe TBI due to a fall. Two control groups: (1) 339 older patients with a soft-Tissue injury; and (2) 113 with a mild-TBI due to a fall. Proxies were required to provide information for a considerable number of patients. Design: Matched case-control study. Settings: The emergency departments of 3 general hospitals. Measures: Sociodemographic, lifestyle behavior, chronic condition, medication use, functional abilities, and fall-related characteristics. Results: When patients with a soft-Tissue injury were assigned to the control group, men were 2.06-fold more likely to have a moderate/severe TBI than women. Subjects who took antiarrhythmics within 4 hours of a fall were 2.59-fold more likely to have a moderate/severe TBI than those who took none. Subjects who were negotiating stairs and getting in/out of the bed/chair were 3.12-fold and 2.97-fold, respectively, more likely to have a moderate/severe TBI than those who fell while walking. Falling backward and sideways was 4.07-fold and 2.30-fold, respectively, more likely to cause a moderate/severe TBI than falling forward. When patients with a mild-TBI were assigned to the control group, results were similar, with the exception that the effect of antiarrhythmic use became nonsignificant and subjects who took 2 or more medications were 3.07-fold more likely to have a moderate/severe TBI than those who took none. Conclusion: Avoiding a head impact during a backward or sideways fall, reducing unnecessary use of polypharmacy and antiarrhythmics, and maintaining safety during stair negotiation and bed/chair transfer may protect an elderly person from a severe brain injury.

AB - Objective: To identify risk factors for traumatic brain injuries (TBIs) during falls in older Taiwanese people. Participants: Case patients consisted of 113 patients aged 60 years or older with a moderate/severe TBI due to a fall. Two control groups: (1) 339 older patients with a soft-Tissue injury; and (2) 113 with a mild-TBI due to a fall. Proxies were required to provide information for a considerable number of patients. Design: Matched case-control study. Settings: The emergency departments of 3 general hospitals. Measures: Sociodemographic, lifestyle behavior, chronic condition, medication use, functional abilities, and fall-related characteristics. Results: When patients with a soft-Tissue injury were assigned to the control group, men were 2.06-fold more likely to have a moderate/severe TBI than women. Subjects who took antiarrhythmics within 4 hours of a fall were 2.59-fold more likely to have a moderate/severe TBI than those who took none. Subjects who were negotiating stairs and getting in/out of the bed/chair were 3.12-fold and 2.97-fold, respectively, more likely to have a moderate/severe TBI than those who fell while walking. Falling backward and sideways was 4.07-fold and 2.30-fold, respectively, more likely to cause a moderate/severe TBI than falling forward. When patients with a mild-TBI were assigned to the control group, results were similar, with the exception that the effect of antiarrhythmic use became nonsignificant and subjects who took 2 or more medications were 3.07-fold more likely to have a moderate/severe TBI than those who took none. Conclusion: Avoiding a head impact during a backward or sideways fall, reducing unnecessary use of polypharmacy and antiarrhythmics, and maintaining safety during stair negotiation and bed/chair transfer may protect an elderly person from a severe brain injury.

KW - fall mechanism

KW - falls

KW - older people

KW - risk factor

KW - traumatic brain injury

UR - http://www.scopus.com/inward/record.url?scp=84947017792&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84947017792&partnerID=8YFLogxK

U2 - 10.1097/HTR.0000000000000093

DO - 10.1097/HTR.0000000000000093

M3 - Article

VL - 30

SP - E9-E17

JO - Journal of Head Trauma Rehabilitation

JF - Journal of Head Trauma Rehabilitation

SN - 0885-9701

IS - 6

ER -