Background: Falls are the most common cause of nonfatal trauma-related hospital admissions among older adults. The objective of this study was to determine whether the quarantine/lockdown elicited by the SARS-CoV-2 pandemic led to a change in the incidence of falls in geriatric patients between March 2020 – December 2020 compared to March 2019 – December 2019 at a Level 1 Trauma Center. We hypothesized there would be an increase in ER admissions for geriatric falls due to a more sedentary lifestyle.
Methods: A retrospective chart review was performed using a large urban level 1 Trauma Center database. The study population included patients age 65 and older who experienced falls between March 2019- December 2019 and March 2020- December 2020. Study variables included ISS, HLOS, ICU LOS, Mechanism of injury, in-hospital mortality, polypharmacy, and comorbid conditions.
Results: A total of 355 patients met the study criteria. Of these, 191 patients (53.8%) were admitted in 2019, and 164 (46.2%) were admitted in 2020. The mean age of the patients in 2019 was 77.2 ± 8.5 years, and in 2020 was 78.6 ± 9.7 years. 52.9% of patients were male in 2019 compared to 58.5% in 2020, and 37.9% of the patients were African American in 2019 compared to 45.7% in 2020. The mortality rate was 4.8% in 2019 and 5.5% in 2020 (p= 0.7). The major comorbidities were hypertension (61% vs 61.3%) and diabetes mellitus (24% vs 27%) in both 2019 and 2020. The mean number of home medications that patients were taking in 2019 was 4.2 ± 4, and in 2020 was 4.6 ± 4 (p=0.9).The mean ISS in 2019 and 2020 was similar (6.13 ± 4.7 versus 6.14 ± 4.8, p=0.9). The mean HLOS was 4.7 ± 6.0 days in 2019 and was 4.4 ± 5.3 days in 2020 (p=0.1). 23.5% of patients were admitted to ICU in 2019 compared to 45.7% in 2020. The average ICU length of stay in 2019 (6.4 ± 5.3 days) was significantly different when compared to 2020 (3.6 ± 3.8 days) (p=0.009).
Conclusions: Contrary to our hypothesis, during COVID-19, the incidence of geriatric admissions due to falls was decreased during the period studied. There were more patients admitted to the ICU in 2020 when compared to 2019, but the ICU length of stay was significantly reduced in 2020 compared to 2019, though the total hospital length of stay remains unchanged. We hypothesize that there appears to be a redistribution of hospital resources due to the COVID-19 pandemic.