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The effect of age on in-hospital mortality among elderly people who sustained fall-related traumatic brain injuries at home: A retrospective study of a multicenter emergency department-based injury surveillance database

  • Yoo Kyung Jeon
    Affiliations
    Department of Emergency Medicine, Seoul National University Bundang Hospital, Seongnam-si, Korea
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  • Joo Jeong
    Correspondence
    Corresponding author at: Department of Emergency Medicine Seoul National University Bundang Hospital 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, Republic of Korea.
    Affiliations
    Department of Emergency Medicine, Seoul National University Bundang Hospital, Seongnam-si, Korea

    Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, Korea
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  • Sang Do Shin
    Affiliations
    Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Korea

    Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, Korea
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  • Kyoung Jun Song
    Affiliations
    Department of Emergency Medicine, Seoul National University Boramae Medical Center, Seoul, Korea

    Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, Korea
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  • Yu Jin Kim
    Affiliations
    Department of Emergency Medicine, Seoul National University Bundang Hospital, Seongnam-si, Korea

    Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, Korea
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  • Ki Jeong Hong
    Affiliations
    Department of Emergency Medicine, Seoul National University Hospital, Seoul, Korea

    Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, Korea
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  • Young Sun Ro
    Affiliations
    Department of Emergency Medicine, Seoul National University Hospital, Seoul, Korea

    Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, Korea
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  • Jeong Ho Park
    Affiliations
    Department of Emergency Medicine, Seoul National University Hospital, Seoul, Korea

    Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, Korea
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      Highlights

      • This study focused on location in the home where fall-related traumatic brain injury in the elderly occurs.
      • The oldest group (age 85 and/or over) was more associated with in-hospital mortality than the young-old (age 65 to 74).
      • In the oldest group, bathroom, stairs, and outdoor space were more dangerous than room, living room, and kitchen.

      Abstract

      Background

      People older than 65 years tend to have traumatic brain injuries (TBIs) more frequently and have a higher mortality rate after TBI than younger individuals. The aim of this study was to determine the effects of age on in-hospital mortality among patients who had fall-related TBIs at home, emphasizing the effect of specific locations in the house on the outcome.

      Methods

      This cross-sectional study was conducted using the Emergency Department-based Injury In-Depth Surveillance (EDIIS) database in South Korea. Patients aged 65 years or older with a slip or fall injury, accidental injury at home, and no major diagnosis other than TBI were included. The primary outcome was in-hospital mortality. Subgroup analysis was conducted to determine the effect of locations on the relationship between age and in-hospital mortality.

      Results

      Of the 2,571,442 patients in the EDIIS database, 9,747 were included in this study. The most common injury location was room or bedroom (29.1%), followed by living room or kitchen (23.0%), bathroom (20.2%), stairs (15.8%), and outdoor spaces of the house (11.9%). There was a significant association between increased in-hospital mortality and oldest old age. The stairs or outdoor spaces of the house was significantly associated with in-hospital mortality compared to rooms inside the house. The oldest age group showed a higher association with in-hospital mortality than the young-old group, especially in the bathroom, stairs, and outdoor spaces of the house.

      Conclusions

      Elderly individuals over the age of 85 are the most vulnerable to fall-related TBI mortality at home. A fall prevention strategy for the oldest-old is needed, especially for the bathroom, stairs, and the ancillary space outside the house.

      Keywords

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