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Title: Secular trends in fall-related hospitalizations in adolescents, youth and adults : a population-based study
Authors: Tang, CTL
Sing, CW
Kwok, TCY
Li, GHY 
Cheung, CL
Issue Date: Jul-2021
Source: The lancet regional health - Western Pacific, July 2021, v. 12, 100183
Abstract: Background: Falls are one of the major causes of injury globally. However, there is a lack of population-based studies on falls among adolescents, young and middle-aged adults. We therefore aimed to conduct a large-scale population study on the secular trend in incidence of fall-related hospitalization.
Methods: A population-wide electronic database, Hong Kong's Clinical Data Analysis and Reporting System (CDARS), was used in this retrospective cohort study. Patients aged≥10, hospitalized with diagnosis of accidental falls (ICD-9-CM E880-E888) from 2005-2018, were included. Outcome measures included the number, age- and sex-standardized incidence rate of fall-related hospital admissions, their length of stay (LOS) and 1-year all-cause mortality. Linear regression and average annual percentage change (AAPC) using joinpoint regression were computed for trend analysis.
Findings: From 2005 to 2018, a total of 336,439 patients aged≥10 were identified with fall-related hospitalization. Among these fall patients, 33.7% occurred at age<60. The number of fall-related hospital admissions episodes increased significantly by 83.7% during the study period. The standardized incidence rate of falls per 1000 person-years increased from 3.67 (95% CI 3.62-3.72) in 2005 to 4.79 (95% CI 4.74-4.84) in 2018. Although the total hospitalized bed-days increased from 178,723 days in 2005, to 299,273 days in 2018 (+67.5%,p<.0001), the median length of stay per episode of falls decreased from 4.90 days to 3.79 days (p<.0001).
Interpretation: Continuous increase in the incidence of fall-related hospitalization in people aged≥10 was observed. This suggested that falls are a public health issue in all ages. Further studies on the differences in the underlying risk factors and comorbidities between younger and older fall patients are warranted.
Funding: None.
Publisher: The Lancet Publishing Group
Journal: The lancet regional health - Western Pacific 
EISSN: 2666-6065
DOI: 10.1016/j.lanwpc.2021.100183
Rights: © 2021 The Author(s). Published by Elsevier Inc. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
The following publication Tang, C. T., Sing, C. W., Kwok, T. C., Li, G. H., & Cheung, C. L. (2021). Secular trends in fall-related hospitalizations in adolescents, youth and adults: a population-based study. The Lancet Regional Health-Western Pacific, 12, 100183 is available at https://doi.org/10.1016/j.lanwpc.2021.100183
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