Year: 2025
Type: other
Abstract: Background: Falls are a leading cause of injury, disability, and healthcare utilization among older adults. Approximately one-quarter of Canadians aged 65 years and older report at least one fall annually, yet long-term provincial trends in fall-related emergency department (ED) use remain poorly described. We aimed to characterize temporal patterns in fall-related ED visits and mortality in Alberta to inform fall prevention and healthy aging strategies. Methods: We conducted a population-based, descriptive time-series study of unintentional fall injuries treated in EDs and urgent-care centres across Alberta from 1998–2023. Encounters were identified in the Alberta Ambulatory Care Classification System using ICD-9 (E880–E886, E888) and ICD-10 (W00–W19) external-cause codes, with age- and sex-specific denominators derived from the Alberta Health Care Insurance Plan registry. Fall-related deaths (1986–2021) were ascertained from provincial mortality records using the same external-cause ranges. Annual age-standardized ED visit and mortality rates per 100,000 population were calculated and stratified by sex, age group, and fall etiology. Joinpoint regression was used to identify significant inflection points and estimate annual percent change (APC) and average APC in rates. Results: From 1998–2023, there were 2,999,578 fall-related ED visits in Alberta, corresponding to an average age-standardized rate of 3,148.72 per 100,000. Females accounted for 52.1% of ED visits, yet males represented 61% of the 5,338 fall-related deaths over the same period. The overall age-standardized ED visit rate increased with an average APC of 0.68% (p<0.05), with two inflection points in 2018 and 2021. Rates rose significantly from 1998–2018, declined between 2018–2021 coincident with the COVID-19 pandemic, and increased again from 2021–2023. Females experienced a higher long-term APC in ED visit rates than males (1.02% vs 0.36%, both p<0.05). In contrast, age-standardized mortality from falls (1986–2021) showed one inflection in 1995, with an initial decline followed by a sustained increase (overall APC 1.56%, p<0.05), and consistently higher mortality rates in males than females. The most common etiologies were other unspecified falls, same-level slips, trips and stumbles, and falls on stairs or due to ice and snow. Interpretation: Fall-related ED visits and mortality in Alberta have increased over multiple decades, with a transient pandemic-related decline in ED presentations followed by rebound. Women experience more fall-related ED visits, whereas men have higher mortality. These findings underscore falls as a persistent and growing public health challenge and support scaling up sex- and age-informed prevention strategies, including multicomponent exercise, medication review, bone health optimization, and home and environmental safety interventions, to reduce injury severity and stabilize future ED demand.
DOI: 10.11575/prism/51886
Language: English
Field: Health Professions
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7204635312