Impact of different drug classes on clinical severity of falls in an elderly population: Epidemiological survey in a trauma center

PurposeCertain classes of drugs have been associated with the risk of falls in elderly individuals. The aim of this study was to evaluate the impact of several classes of drugs on fall-related injuries in individuals aged 65 years or older.MethodsData on all the emergency department (ED) visits for trivial falls during the year 2013 were retrieved from the database of the Academic Hospital of Parma. The individual reports of the visits were analyzed to evaluate where and how the patient fell, the drugs currently taken, the type, and severity of injury.ResultsA total of 2533 visits for trivial falls in patients aged 65 years or older were analyzed. We found a significant positive correlation between age and total number of drugs (r = 0.063; p < 0.03), but no correlation between the number of ED visits for trivial falls and the number of drugs (r = 0.001; p < 0.984). Anticoagulants [odds ratio (OR), 1.59; 95% confidence interval (CI), 1.22–2.07], antiplatelets (OR, 1.41; 95% CI, 1.12–1.79), and narcotic analgesics (OR, 2.38; 95% CI, 1.23–4.62) were predictors of hospital admission. Antiplatelets (OR, 2.02; 95% CI, 1.56–2.62), anticoagulants (OR, 1.89; 95% CI, 1.141–2.55), antihypertensive (OR, 1.44; 95% CI, 1.08–1.93), and psychotropic drugs (OR, 1.93; 95% CI, 1.09–3.44) were predictors of traumatic brain injury. Other classes of drugs were not related to any of the considered outcomes.ConclusionsTo reduce the risk of falling in elderly patients, a major focus should be placed on optimization of antihypertensives, narcotic analgesics, and psychotropic drugs administration. The risk-to-benefit ratio of anticoagulants and antiplatelet drugs should be individually tailored, to minimize the risk of adverse outcome of falls.