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500 The effect of comorbidity and gender on in-hospital mortality in patients with falls: results from a large asian tertiary care hospital
  1. Yong Yang1,2,
  2. Emily Ho3,
  3. Julian Thumboo2,4,
  4. Truls Østbye2,
  5. Yee Sien Ng5,
  6. Chern Hui Jeffrey Fong6,
  7. Kok Yong Fong2,7
  1. 1Department of Epidemiology, Medical Board, Singapore General Hospital, Outram Road, Singapore 169608
  2. 2Duke-NUS Graduate Medical School, 8 College Road, Singapore 169857
  3. 3Department of Endocrinology, Singapore General Hospital, Outram Road, Singapore 169608
  4. 4Department of Rheumatology and Immunology, Singapore General Hospital, Outram Road, Singapore 169608
  5. 5Department of Rehabilitation Medicine, Singapore General Hospital, Outram Road, Singapore 169608
  6. 6Healthcare Analytics, Integrated Health Information Systems (IHIS), SingHealth Corporate Office, 6 Serangoon North Ave 5, Singapore 554910
  7. 7Medical Board, Singapore General Hospital, Outram Road, Singapore 169608

Abstract

Background Falls and fall-related injuries are a major public health issue among older adults worldwide. Causes and prognostic indicators of death in older patients with fall are lacking in Asian countries, especially in local older population. We aimed to assess the disease burden of fall and the usefulness of Charlson comorbidity index (CCI) and male sex as risk adjusted hospital mortality predictors in older Asian patients with fall using hospital administrative database. Methods: Historical cohort study of hospital discharge database from 1 January 2004 to 30 June 2015 to identify cases with fall and comorbidity using International Statistical Classification of Diseases and Related Health Problems, 9th Revision, Australian Modification (ICD-9/10-AM) codes.

Results Over the study period, 16346 patients met the criteria of fall with hospital mortality rate of 4.3%. The hospital mortality rates (2.3%, 4.9%, 6.5%, and 10.9% respectively, P < 0.001) and hospital length of stay (geometric mean, 5.3, 6.1, 7.3, and 6.7 days, respectively, P < 0.001) increased consistently for patients with CCI ranging from none, low, moderate to high grade, respectively. Logistic regression model analysis showed that CCI (odds ratio, OR 5.7 high vs. none, p < 0.001) and male sex (OR 2.1, p < 0.001) were significant and independent predictors of hospital mortality. Similar results were also seen with hospital length of stay by zero-truncated negative binomial regression model analysis. Conclusion: The burden of fall is high in this older Asian population. Comorbidities and male sex were some of the most important contributors to hospital mortality and resource utilisation.

  • fall
  • Charlson Comorbidity Index
  • hospital mortality
  • ICD-9/10-AM

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