The leading cause of traumatic injuries treated at Oregon Health & Science University now involves people, usually older, falling over on flat ground.
Known as falls to ground level, this form of injury accounted for 22% of all trauma patients treated at OHSU Hospital in 2020 – the largest cause of traumatic injury and a sharp increase in the past five years. . While it may not seem as dangerous as other leading causes – including gunshots, stabbings and motor vehicle crashes – this seemingly innocuous incident is in fact now the second leading cause of death by unintentional injury in the world.
The reason: an aging population more vulnerable to falls. Many of these injuries can be life threatening, often due to underlying medical conditions exacerbated by the impact.
“Gravity triumphs” Martin Schreiber, MD, Division Chief for Trauma, Critical Care and Acute Care Surgery at OHSU School of Medicine. “Over the past three or four years, falls to ground level have overtaken motor vehicle crashes as the leading cause of trauma, not only here but across the country.
“It is one of the biggest problems in the United States today.”
OHSU, one of Oregon’s two Level 1 trauma centers, treated a total of 685 people for falls to ground level in the 2020 calendar year – a large increase from 465 of those injuries treated in 2016. More than 70% of these cases involved people over the age of 65.
An OHSU geriatrician says the problem is rooted in a burgeoning population of older people.
“The fastest growing demographic group in the United States is those over 85,” said Katie Drago, MD, Assistant Professor of Medicine (General Internal Medicine and Geriatrics) at the OHSU School of Medicine. “It’s wonderful that people are living longer, but it also means that we are seeing more cases of traumatic injuries from falls at ground level. “
Drago said that after a first fall, the elderly are two to three times more likely to fall again.
“If we can do things to get out of this cycle, then we can actually reduce their risk of injury – and they can continue to live independently,” she said. “The fall is not inevitable.”
As part of Falls Prevention Awareness Week, September 20-24, the National Council on Aging has partnered with healthcare workers to focus on actions to reduce falls to reduce falls. ensure that older people can live safely and independently.
Drago said she emphasizes the importance of physical activity with her patients, including aerobic exercise, strength training, and balance through activities such as tai chi. She advises older people to make exercise part of their daily routine.
“Inertia really kills,” she said. “Bodies in motion stay in motion.”
Caring for Medication
Drago said falls to ground level are usually not due to a single factor, but could be a combination of factors. For example, drugs can combine unexpectedly, resulting in dizziness that contributes to the fall.
She often works with her patients to compile long lists of medications and supplements. It is also worth considering whether bifocals used for reading are not ideal for getting around.
Seeing a health care provider every time a person falls is imperative, she said.
“Usually, people won’t be able to distinguish on their own if they’ve just tripped – or if they maybe have a major neurological or heart problem that needs to be treated,” Drago said. “If you’ve fallen, you should talk to your primary care provider. “
To go through
Drago said many cases arrive in infirmaries as a result of a simple mess. Someone gets up to go to the bathroom at night and trips over a stack of books, or their hallway is not wide enough to use a cane without bumping into a wall, or overgrown shrubs are encroaching on the aisles around the House.
Keeping a clear path allows older people to minimize the risk of falling and continue to live independently.
“Little things like this can make a big difference to people,” Drago said.