Stair-related falls in the USA: traumatic brain injury and the role of alcohol intoxication

Abstract

IntroductionFalls are a leading cause of head injury in the USA. Stair-related fall injuries are common and often more serious than same level falls. Alcohol is a known contributor to unintentional injuries, and often associated with fall-related injuries, specifically falls occurring on stairs. The objective was to examine the association between alcohol use and head injuries (traumatic brain injuries (TBIs) or craniomaxillofacial (CMF) injuries) among persons aged 15–64 presenting to an emergency department (ED) with an injury resulting from a fall on stairs.MethodsUsing the 2019 National Electronic Injury Surveillance System, US ED records were examined. Injuries due to falling on stairs were retrieved, with the role of alcohol in the outcome of TBI and CMF injuries examined. Prevalence ratios (PR), adjusted for covariates (blood alcohol level screening, patient demographics, drug use, disposition) were obtained from average marginal predictions derived from logistic regression models.ResultsAn estimated 687 902 patient visits related to falls on stairs occurred during the study period. Patients who presented with alcohol intoxication had a higher prevalence of TBI (PR 2.7 95% CI 2.3 to 3.1) and CMF injuries (PR 2.5; 95% CI 2.3 to 2.8). PRs were more pronounced among patients with blood alcohol concentration ≥0.1, as was hospital admission.ConclusionsStair-related falls represent a common cause of ED visits for falls in the USA. Alcohol intoxication had a detrimental effect on the prevalence of TBI and CMF. A multimodal treatment approach may be beneficial given the complex interrelationship between the injury type and alcohol.

Factors associated with higher alcohol concentrations in emergency department presentations: PACE study

“…Alcohol consumption at high levels is known to be associated with greater risk of injury from acute intoxication and disease from ongoing, frequent consumption [1,2]. Patients with high levels of alcohol use are also known to experience greater risk of complications, increased care costs and higher mortality when being treated in acute care settings [3][4][5].…”

Sedentary behaviour among older adults residing in flat and hilly neighbourhoods and its association with frailty and chronic disease status

“…Older adults are generally frail and may lack the functional ability for climbing and descending hills. Moving up and down steep hills is analogous to using stairs, which can be associated with falls in older adults [ 8 ]. Older adults would avoid types of PA (e.g., jogging or walking in a hilly neighbourhood) that their physical functional ability cannot support.…”