Citation

Schellenberg M, Inaba K, Chen J, Bardes JM, Crow E, Lam L, Benjamin E, Demetriades D. J. Surg. Res. 2019; 234: 283-286.

Affiliation

Division of Trauma and Surgical Critical Care, LAC+USC Medical Center, University of Southern California, Los Angeles, California.

Copyright

(Copyright © 2019, Elsevier Publishing)

DOI

10.1016/j.jss.2018.09.044

PMID

30527486

Abstract

BACKGROUND: When ground-level falls occur in the bathroom, there is particular potential for morbidity and mortality given the high density of hard surfaces. Risk factors are not clearly defined by the existing literature. The objective of this study was to define the epidemiology, injury patterns, and outcomes after falls in the bathroom.

MATERIALS AND METHODS: All patients presenting to LAC+USC Medical Center (01/2008-05/2015) after a fall in the bathroom (ICD-9 code E884.6) were included. Demographics, injury data, investigations, procedures, and outcomes were collected.

RESULTS: Fifty-seven patients were included, with mean age 45 y (range 0-92). All ages were affected, with ages 41-60 y at highest risk. Common comorbidities included cardiovascular disease (n = 23, 40%), neuromuscular disorders (n = 13, 23%), and diabetes (n = 9, 16%). Ten patients (18%) were intoxicated. Home medications included antihypertensives (n = 18, 32%), antipsychotics (n = 9, 16%), and anticoagulants (n = 8, 14%). Common investigations included X-rays (n = 41, 72%) and CT scans of the head (n = 20, 35%). The most frequent injuries were contusion/laceration (n = 45, 79%), fracture (n = 12, 21%), and traumatic brain injury (n = 7, 12%). Most patients did not require hospital admission (n = 46, 81%), although 4 (7%) needed intensive care unit care and operative intervention (ORIF [n = 2, 4%] or craniectomy [n = 2, 4%]). Mortality was low (n = 1, 2%). Most patients were discharged home (n = 40, 70%).

CONCLUSIONS: All ages, especially 41-60 y, are susceptible to falls in the bathroom. Despite the potential for serious injury, most do not require hospital admission. Risk factors include drugs/alcohol, cardiovascular disease, neuromuscular disorders, and diabetes. Efforts to minimize fall risk should be directed toward these individuals.

Copyright © 2018 Elsevier Inc. All rights reserved.

Language: en

Keywords

Accidental falls; Bathroom falls; Elderly; Ground-level falls; Trauma