Mortality after falls in Amsterdam; Data from a retrospective cross sectional study

• Main Authors: N.A.G. Hakkenbrak, W.P. Zuidema, Q.G.H. Rikken, J.A. Halm, T. Dorn, U.J.L. Reijnders, G.F. Giannakopoulos
• Format: Article
• Language: English
• Published: Elsevier 2020-12-01
• Series: Forensic Science International: Reports
• Subjects: Mortality; Fall; Height; Mechanism of injury
• Online Access: http://www.sciencedirect.com/science/article/pii/S2665910720300074

Introduction: Annually, approximately 3600 people decease as a result of a fall in the Netherlands, according to the Statistics Netherlands. The aim of this study is to evaluate the demographic parameters, fall characteristics and resulting injury patterns of this group in the region of Amsterdam. Methods: All patients deceased as a result of injury due to a fall in the period July 1st 2013 until July 1st 2018 in the region of Amsterdam were included. Data were collected from the database (Formatus) of the Department of Forensic Medicine (Public Health Service Amsterdam). Results: During the study period 1258 patients deceased after a fall. The median age was 86 years (0–103 years) and 41 % was male. A psychiatric disease, was diagnosed or suspected in 44 % of the population of which cognitive impairment, including dementia, was encountered in most of the cases (82 %). The majority of the falls happened at home (47 %) or at nursing facilities. A minority (1.3 %) was work related. Over 81 % of the falls was from standing position, 17.6 % was not from standing position of which 80.1 % regarded falls from stairs. The majority was male. Multitrauma patients accounted for 17.1 % of the population. From the remaining 1040 patients, 61.7 % sustained one or more injuries to the pelvis or extremities. Central nervous system (CNS) injuries were described in 31.3 % of the patients. Mortality was in 26.8 % of the cases due to primary CNS injury, 62.3 % was due to complications of which clinical deterioration (58.7 %) and infection (17.1 %) were the most common. Conclusions: In the region of Amsterdam the majority of deaths due to a fall regards the geriatric population. Fall from standing position and mortality due to complications, mainly clinical deterioration, accounted for the majority of deaths. Intervention to prevent falls, and thereby complications, need more awareness to reduce mortality.