Geriatric fractures presenting to emergency departments in the United States: an epidemiologic analysis of national injury data from 2019 to 2023.

Abstract

Introduction Geriatric fractures are a major contributor of morbidity and mortality in elderly patients and represent a large resource burden on healthcare institutions across the United States. Elderly populations are predicted to increase in the coming decades, motivating epidemiological studies that may inform more effective and targeted prevention measures for these injuries. Methods Data analyzed in this study was extracted from the National Electronic Injury Surveillance System (NEISS), a public database representing approximately 100 US EDs to provide national injury estimates. NEISS was queried for all fracture ED admissions among patients age 65 and older. Fracture events were restricted to injuries from January 1, 2019 to December 31, 2023. Results A geriatric fracture NEISS query resulted in 82,953 ED visits, extrapolating to a total national estimate of 3852,261 fractures presenting to US EDs across the study period. The overall hospitalization rate was 54.8 %, increasing to 74.5 % by age 99. Linear regression of fractures rates by year demonstrated a significant increase in male fractures over time (p = 0.047, β = 7688). Compared to females, males were also more likely to sustain trunk fractures and become injured at sporting facilities. Older patients also saw higher rates of trunk fractures (including upper and lower trunk), while rates of extremity fractures (upper and lower extremities) decreased with age. Fractures in the home also decreased with age, while those occurring on public property (including assisted living facilities) increased with age. Conclusion Increasing fracture rates among males indicates an opportunity for improved prevention measures among men 65 and older. Males were also more likely to sustain fractures while participating in sports, and may therefore benefit from education programs on fracture risk. Geriatric fractures were more likely to occur on public property such as sidewalks and assisted living facilities as patients aged, demonstrating the need for improved precautionary measures such as low-floor beds, hip protectors, fall alarms, and wearable devices.