The authors have no financial or proprietary interest in the subject matter or materials discussed in the manuscript. All authors participated in data interpretation and manuscript preparation. B.J, M.D, M.C, J.R, and L.S analyzed the data. M.K, B.J, M.D, L.B, and M.D collected the data. M.K, L.B, B.J, J.R, L.S, M.D searched the literature. M.K, M.D, L.S, M.C, B.J, and M.D designed this study. The overall rates of SNF/Rehab disposition significantly Authors Contributions Our results also show that the incidence of GLFs among geriatric patients increased to about 30% over the study period, and there was an increase in rates of adverse discharge disposition and loss of functional independence mostly upon admission to non-level I trauma centers. The results of our 5-y (2011-2015) analysis of the ACS-NTDB indicate that almost 39% of all geriatric trauma patients admitted to hospitals were because of GLFs. In addition, 31% of patients suffered from a head injury following a GLF the median head AIS among those patients was 3 (2-4). The median GCS score was 15 (14-15), and the median ISS was 9 (4-10). The mean age of our study population was 78 ± 7 years, 63% were female, and 85% were white. We analyzed a total of 1,017,326 geriatric trauma patients, of which 400,268 (39%) presented after GLFs. 12 This study was exempt from approval by the Institutional Review Board of the University of Arizona because the NTDB contains only de-identified data. It contains more than 7.5 million electronic records, with contributions from more than 900 trauma centers across the United States. The NTDB is the largest trauma data repository, and it is maintained by the American College of Surgeons (ACS). We performed a 5-y (2011-2015) retrospective analysis of the National Trauma Databank (NTDB). We hypothesized that the incidence of falls and adverse discharge disposition increased over time and that there was an increase in adverse discharge disposition upon admission to a non-level-I trauma center. We also aim to analyze discharge dispositions according to specific trauma center levels. Our descriptive study aims to analyze the trend of geriatric GLFs on the national level in terms of overall incidence, discharge disposition, and distribution among different trauma centers. However, there is a paucity of research exploring the trends in discharge disposition in geriatric GLF patients. The literature also shows that the incidence of geriatric trauma is increasing over time 11. 7įurthermore, studies of patients with severe trauma and specific critical injuries show that significant disparities in clinical outcomes exist between different levels of trauma centers.8, 9, 10 Nevertheless, there is a paucity of data regarding the distribution and discharge dispositions of elderly GLF patients treated at different trauma-center-levels. 6 Although mortality following GLFs is low, morbidity following GLFs is substantial, and nearly 40% of all nursing home admissions are in some way related to falls. The literature suggests that one-third of GLFs are associated with head or spinal cord injury, leading to a detrimental outcome. Typically, a GLF is reported as a minor injury mechanism, but it is often associated with adverse outcomes in the geriatric population. 5 Although high-level falls do occur, ground-level falls (GLFs) outnumber them. 3, 4 Trauma following falls poses a significant health risk in the geriatric population it is associated with the third-highest case-fatality rate after firearm injuries and motor vehicle crashes. Recent estimates suggest that 3 million geriatric patients are seen in emergency departments each year for falls, accounting for approximately $50 billion worth of annual national medical costs. 1, 2 In addition, one of the most common causes of trauma among older adults is falls. Injured geriatric adults are the fastest-growing subset of all trauma patients admitted to trauma centers, and trauma is one of the leading causes of death in this age group.
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