Gender-Specific Patterns of Injury in Older Adults After a Fall from a Four-Wheeled Walker (Rollator): Retrospective Study from a Swiss Level 1 Trauma Centre.

AIM

As the population is aging, falls by older people, in particular falls from four-wheeled walkers ("rollators"), are a growing problem. These falls must be examined by targeted research and interventions that incorporate gender differences. Therefore, this study examined the injury patterns of elderly patients admitted to a tertiary trauma centre in Switzerland after falls from rollators and focussed on gender differences.

METHODS

This was a retrospective single-centre study for the period from May 2012 to December 2019 which included elderly patients (≥65 years) who had suffered a fall from a rollator. Injury history, patient data, demographic information, and patient outcomes were compared between males and females, with the data sourced from the Ecare patient database, which contains all information related to patient visits and treatment procedures.

RESULTS

A total of 152 eligible patients were included in the analysis, with 56.6% hospitalised at our facility and 14.5% transferred to another hospital. The cohort comprised 50 (32.9%) males and 102 (67.1%) females. Males were more prevalent in the 75-84 age group, while females predominated in the 85 and older group, and this difference was statistically significant ( = 0.043). Osteoporosis was significantly more common in females (37.3% vs. 10%, ≤ 0.001). Consequently, treatment with vitamin D and/or calcium was also significantly more prevalent among women (29.4% vs. 8%, = 0.003). Most falls occurred at home (22.4%) or in nursing care facilities and rehabilitation centres (22.4%), without gender-based differences ( = 0.570). Men were six times more likely than women to sustain injuries when under the influence of alcohol ( = 0.002). Fractures to the lower extremities were the most common injuries, accounting for 34.2% of all injuries, with no statistically significant differences between groups ( = 0.063). Head injuries occurred in 34.9% of patients, with a trend towards more injuries in males (44% vs. 30.4%, = 0.098). The cumulative rates of fractures to the pelvis, upper extremities, and lower extremities were significantly higher in females (59.8%) than in males (38%), = 0.011. In-hospital mortality was significantly higher in men than in women (12.9% vs. 2.9%, = 0.026). Operative procedures were significantly more common in women (33% vs. 16.3%; < 0.001).

CONCLUSION

Women were more frequently affected by falls related to rollators than men. Most falls occurred at home, in nursing care facilities, or rehabilitation centres, with no significant gender-based differences. There was a trend toward more head injuries in males, while the cumulative fracture rate of the pelvis, upper extremities, and lower extremities was significantly higher in females. In-hospital mortality was more than four times higher in men. These findings may guide the development of gender-specific interventions to reduce rollator-related injuries in the vulnerable elderly population.