Standing height falls are the leading cause of major trauma among older people - report

Standing height falls are the leading cause of major trauma among older people, with the vast majority of accidents happening in the home, a new audit has found.

On Wednesday, the National Office of Clinical Audit published the Major Trauma Audit Report Focused on Older Adults. Major trauma is defined as an incident resulting in life-threatening or life-changing injuries.

The report focused on the care of 11,145 adults aged 65 and above who had major trauma injuries between 2017-2021.

Low falls of less than two metres – meaning standing height – were the leading cause of major trauma in this demographic, accounting for 82 per cent of injuries. Some 70 per cent of all accidents occurred at home, the audit said, compared to 36 per cent in younger patients.

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However, the report noted the increase in accidents at home coincided with the Covid-19 pandemic, during which point the public was largely expected to be at home amid public health restrictions.

For those injured in the home, the most commonly injured body regions were limbs (27 per cent), head (23 per cent), spine (23 per cent) and chest (16 per cent).

One-third of older patients in the audit had an injury in the most severe category. The median age of patients was 79 years, with 74 per cent having pre-existing comorbidities.

Some 30 per cent of those aged 65 or older with major trauma underwent surgical intervention.

The median length of hospital stay for older adults was 12 days, which is significantly longer than that of younger patients, who stay seven days.

About 22 per cent of older adults were discharged to a nursing home, while 44 per cent were discharged directly home from hospital.

Launching the report, Prof Conor Deasy, clinical lead for major trauma, said the findings highlight a need for a more tailored approach to treatment.

“Older adults who have sustained trauma present differently than younger adults with relatively innocuous mechanisms of injury, like a low fall causing serious life threatening injuries. Many have other medical conditions in addition to the traumatic injuries, complicating their treatment and recovery,” Prof Deasy said.

“Low falls are the leading cause of major trauma in older adults but that doesn’t always trigger a high level of suspicion compared to other accidents like car crashes.

“Older adults with trauma need a more tailored and specialised approach to their care. The data in the report will enable these tailored pathways to be developed, ensuring a better quality service and ultimately better outcomes for older adults with major trauma.”

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