Fall-related Emergency Department Visits Involving Alcohol Among Older Adults

Overview

Journal J Safety Res

Specialty Critical Care

Date 2020 Sep 21

PMID 32951773

Citations 12

Authors

Iju Shakya

Gwen Bergen

Yara K Haddad

Ramakrishna Kakara

Briana L Moreland

Affiliations

Soon will be listed here.

Abstract

Problem: Falls are the leading cause of injury deaths among adults aged 65 years and older. Characteristics of these falls may vary with alcohol use.

Objective: Describe and compare characteristics of older adult fall-related emergency department (ED) visits with indication of alcohol to visits with no indication.

Methods: Using nationally-representative 2015 National Electronic Injury Surveillance System-All Injury Program data, we compared demographic characteristics for fall-related ED visits by indication of alcohol consumption. Alcohol-indicated ED visits were matched on age group, sex, treatment month, and treatment day to ED visits with no alcohol indication using a 1:4 ratio and injury characteristics (i.e., diagnosis, body part injured, disposition) were compared.

Results And Discussion: Of 38,640 ED records, 906 (1.9%) indicated use of alcohol. Fall-related ED visits among women were less likely to indicate alcohol (1.0%) compared to ED visits among men (3.8%). ED visits indicating alcohol decreased with age from 4.1% for those 65-74 years to 1.5% for those 75-84 and <1% for those 85+. After controlling for age-group, sex, and month and day of treatment, 17.0% of ED visits with no alcohol indication had a traumatic brain injury compared to 34.8% of alcohol-indicated ED visits. Practical applications: Alcohol-indicated fall ED visits resulted in more severe head injury than those that did not indicate alcohol. To determine whether alcohol use should be part of clinical risk assessment for older adult falls, more routinely collected data and detailed information on the amount of alcohol consumed at the time of the fall are needed.

Citing Articles

Risk Factors for Fall-Related Mild Traumatic Brain Injuries Among Older Adults: A Systematic Review Highlighting Research Gaps.

Okrah A, Tharrington S, Shin I, Wagoner A, Woodsmall K, Jehu D Int J Environ Res Public Health. 2025; 22(2).

PMID: 40003481 PMC: 11854998. DOI: 10.3390/ijerph22020255.

Orbital Trauma Epidemiologic Characteristics by Life Stage.

Irfan A, Punjabi N, Suresh A, Waldrop I, Inman J, Sheets N Craniomaxillofac Trauma Reconstr. 2024; :19433875241275102.

PMID: 39553816 PMC: 11562991. DOI: 10.1177/19433875241275102.

Alcohol use is associated with intracranial hemorrhage in older emergency department head trauma patients.

Zirulnik A, Liu S, Wells M, Alter S, Engstrom G, Solano J J Am Coll Emerg Physicians Open. 2024; 5(4):e13245.

PMID: 39086794 PMC: 11289673. DOI: 10.1002/emp2.13245.

Alcohol and Substance Use Among the Working Age Population: A Nationwide Study of Fall-Related Emergency Department Visits.

Bhagavathula A, Aldhaleei W J Stud Alcohol Drugs. 2024; 85(3):330-338.

PMID: 38270911 PMC: 11218450. DOI: 10.15288/jsad.23-00330.

Could reasons for admission help to screen unhealthy alcohol use in emergency departments? A multicenter French study.

Chabert J, Lambert C, Cabe J, Cherpitel C, Rolland B, Moustafa F Front Psychiatry. 2023; 14:1271076.

PMID: 38098633 PMC: 10719849. DOI: 10.3389/fpsyt.2023.1271076.

References

Chang V, Do M . Risk factors for falls among seniors: implications of gender. Am J Epidemiol. 2015; 181(7):521-31. DOI: 10.1093/aje/kwu268. View

Sarmiento K, Thomas K, Daugherty J, Waltzman D, Haarbauer-Krupa J, Peterson A . Emergency Department Visits for Sports- and Recreation-Related Traumatic Brain Injuries Among Children - United States, 2010-2016. MMWR Morb Mortal Wkly Rep. 2019; 68(10):237-242. PMC: 6421963. DOI: 10.15585/mmwr.mm6810a2. View

Chatha H, Sammy I, Hickey M, Sattout A, Hollingsworth J . Falling down a flight of stairs: The impact of age and intoxication on injury pattern and severity. Trauma. 2018; 20(3):169-174. PMC: 6027135. DOI: 10.1177/1460408617720948. View

Cawthon P, Harrison S, Barrett-Connor E, Fink H, Cauley J, Lewis C . Alcohol intake and its relationship with bone mineral density, falls, and fracture risk in older men. J Am Geriatr Soc. 2006; 54(11):1649-57. DOI: 10.1111/j.1532-5415.2006.00912.x. View

Florence C, Bergen G, Atherly A, Burns E, Stevens J, Drake C . Medical Costs of Fatal and Nonfatal Falls in Older Adults. J Am Geriatr Soc. 2018; 66(4):693-698. PMC: 6089380. DOI: 10.1111/jgs.15304. View

Woods C, Jones R, Usher K . The impact of unintentional alcohol-related falls on emergency departments. Australas Emerg Care. 2019; 22(1):22-27. DOI: 10.1016/j.auec.2018.11.001. View

Zhang X, Yu Z, Yu M, Qu X . Alcohol consumption and hip fracture risk. Osteoporos Int. 2014; 26(2):531-42. DOI: 10.1007/s00198-014-2879-y. View

Cherpitel C, Ye Y, Bond J, Borges G, Monteiro M . Relative risk of injury from acute alcohol consumption: modeling the dose-response relationship in emergency department data from 18 countries. Addiction. 2014; 110(2):279-88. PMC: 4302018. DOI: 10.1111/add.12755. View

Heuberger R . Alcohol and the older adult: a comprehensive review. J Nutr Elder. 2010; 28(3):203-35. DOI: 10.1080/01639360903140106. View

10.

Smith G, Branas C, Miller T . Fatal nontraffic injuries involving alcohol: A metaanalysis. Ann Emerg Med. 1999; 33(6):659-68. View

11.

Cunningham R, Harrison S, McKay M, Mello M, Sochor M, Shandro J . National survey of emergency department alcohol screening and intervention practices. Ann Emerg Med. 2010; 55(6):556-62. DOI: 10.1016/j.annemergmed.2010.03.004. View

12.

Karibe H, Hayashi T, Narisawa A, Kameyama M, Nakagawa A, Tominaga T . Clinical Characteristics and Outcome in Elderly Patients with Traumatic Brain Injury: For Establishment of Management Strategy. Neurol Med Chir (Tokyo). 2017; 57(8):418-425. PMC: 5566701. DOI: 10.2176/nmc.st.2017-0058. View

13.

Peterson A, Kegler S . Deaths from Fall-Related Traumatic Brain Injury - United States, 2008-2017. MMWR Morb Mortal Wkly Rep. 2020; 69(9):225-230. PMC: 7367089. DOI: 10.15585/mmwr.mm6909a2. View

14.

Tait R, French D, Burns R, Byles J, Anstey K . Alcohol, hospital admissions, and falls in older adults: a longitudinal evaluation. Int Psychogeriatr. 2013; 25(6):901-12. DOI: 10.1017/S1041610213000173. View

15.

Paniagua M, Malphurs J, Phelan E . Older patients presenting to a county hospital ED after a fall: missed opportunities for prevention. Am J Emerg Med. 2006; 24(4):413-7. DOI: 10.1016/j.ajem.2005.12.005. View

16.

Holton A, Gallagher P, Fahey T, Cousins G . Concurrent use of alcohol interactive medications and alcohol in older adults: a systematic review of prevalence and associated adverse outcomes. BMC Geriatr. 2017; 17(1):148. PMC: 5512950. DOI: 10.1186/s12877-017-0532-2. View

17.

Barell V, Aharonson-Daniel L, Fingerhut L, Mackenzie E, Ziv A, Boyko V . An introduction to the Barell body region by nature of injury diagnosis matrix. Inj Prev. 2002; 8(2):91-6. PMC: 1730858. DOI: 10.1136/ip.8.2.91. View

18.

Castle I, Yi H, Hingson R, White A . State variation in underreporting of alcohol involvement on death certificates: motor vehicle traffic crash fatalities as an example. J Stud Alcohol Drugs. 2014; 75(2):299-312. PMC: 3965684. DOI: 10.15288/jsad.2014.75.299. View

19.

Merrick E, Horgan C, Hodgkin D, Garnick D, Houghton S, Panas L . Unhealthy drinking patterns in older adults: prevalence and associated characteristics. J Am Geriatr Soc. 2007; 56(2):214-23. DOI: 10.1111/j.1532-5415.2007.01539.x. View

20.

Johnston J, McGovern S . Alcohol related falls: an interesting pattern of injuries. Emerg Med J. 2004; 21(2):185-8. PMC: 1726307. DOI: 10.1136/emj.2003.006130. View