ArticleInjury epidemiology2024
Clinical trauma severity of indoor and outdoor injurious falls requiring emergency medical service response.
Article in Injury epidemiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Factors Associated with a Disposition-Based Indicator of Severe Injury Among Older Adults with Fall-Related Injuries: A Secondary Analysis of the 2023 Emergency Department-Based Injury In-Depth Surveillance.Healthcare (Basel, Switzerland) · 2026Article
- Determinants of implementing fall risk screening for older adults in primary care settings: protocol for a scoping review.BMJ open · 2026Article
- Health and Functioning of Community-Dwelling Older Adults in Urban and Rural Areas of Portugal-What Are the Implications for Physiotherapy Care?International journal of environmental research and public health · 2025Article
- When Pedestrian Crossings Become Danger Zones: Trauma and Mortality Risks in Elderly Pedestrians.International journal of environmental research and public health · 2025Article
- Prevalence and Risk Factors of Unintentional In-Home Injuries in Older Adults.Medicina (Kaunas, Lithuania) · 2025Article
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Funding
Abstract
backgroundInjurious falls represent a significant public health burden. Research and policies have primarily focused on falls occurring indoors despite evidence that outdoor falls account for 47-58% of all falls requiring some medical attention. This study described the clinical trauma severity of indoor versus outdoor injurious falls requiring Emergency Medical Services (EMS) response.
methodsUsing the 2019 National Emergency Medical Services Information System (NEMSIS) dataset, we identified the location of patients injured from falls that required EMS response. We classified injury severity using (1) the Revised Trauma Score for Triage (T-RTS): ≤ 11 indicated the need for transport to a Trauma Center; (2) Glasgow Coma Scale (GCS): ≤ 8 and 9-12 indicated severe and moderate neurologic injury; and (3) patient clinical acuity by EMS: Dead, Critical, Emergent, Low.
resultsOf 1,854,909 encounters for patients with injurious falls, the vast majority occurred indoors (n = 1,596,860) compared to outdoors (n = 152,994). For patients who fell indoors vs outdoors on streets or sidewalks, the proportions were comparable for moderate or severe GCS scores (3.0% vs 3.9%), T-RTS scores indicating need for transport to a Trauma Center (5.2% vs 5.9%) and EMS acuity rated as Emergent or Critical (27.7% vs 27.1%). Injurious falls were more severe among male patients compared to females and males injured by falling on streets or sidewalks had higher percentages for moderate or severe GCS scores (5.2% vs 1.9%) and T-RTS scores indicating the need for transport to a Trauma Center (7.3% vs 3.9%) compared to falling indoors. Young and middle-aged patients who fell on streets or sidewalks had higher proportions for a T-RTS score indicating the need for Trauma Center care compared to those in this subgroup who fell indoors. Yet older patients injured by falling indoors were more likely to have a T-RTS score indicating the need for transport to a Trauma Center than older patients who fell on streets or sidewalks.
conclusionsThere was a similar proportion of patients with severe injurious falls that occurred indoors and outdoors on streets or sidewalks. These findings suggest the need to determine outdoor environmental risks for outdoor falls to support location-specific interventions.
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