[Associations between fall injury rates and instrumentation, equipment, and use among community-dwelling older adults: Computation using emergency medical service records].

Abstract

Objective　This study aimed to examine the instrumentation, equipment, and use associated with falls among community-dwelling older adults, assess the injury rates by instrumentation, equipment, and use according to the characteristics of individuals with injuries, and identify the instrumentation, equipment, and use that cause severe injury.Methods　We analyzed individuals aged ≥ 65 years who experienced falls on their property and required emergency medical transport to a hospital in 2019. The fire departments in Saitama Prefecture provided relevant emergency records. We calculated injury rates and 95% confidence intervals (CI) per 100,000 person-years for each age group (classified as 65-74, 75-84, and ≥ 85 years), sex for each type of instrumentation, equipment, and use, and the number of moderate or severe injuries and their percentages. The instrumentation and equipment associated with falls were categorized using ICD-10 and subdivided according to the conditions of use. Logistic regression analysis was conducted to identify instrumentation, equipment, and use associated with moderate or severe injuries, after adjusting for sex and age groups, with the floor as a reference.Results　This study included 4,421 patients. Patients were categorized according to 44 types of instrumentation, equipment, and use associated with falls. Overall, 2,154 cases (48.7%) were classified as moderate or severe injuries. Older adults had higher fall injury rates on floors (injury rates; 450.9, 95% CI; 434.5-467.9), stairs (76.6, 69.9-83.8), beds (25.5, 21.7-29.8), steps (21.2, 17.7-25.1), and toilets (14.5, 11.6-17.8), with differences on instrumentation, equipment, and use, sex, and age groups. Logistic regression analysis revealed that the odds ratio (OR) for moderate or severe injuries was higher for falls occurring on the roof (OR; 8.95, 95% CI; 1.52-169.40).Conclusion　Fall injury rates and the characteristics of injured individuals among community-dwelling older adults differ based on the instrumentation, equipment, and use associated with falls. The implementation of measures to mitigate the external factors associated with this risk is necessary.