Falls may be sending more Canadians to hospital, study suggests

A raised bit of concrete on a sidewalk. An icy patch on the road. A misstep on the stairs at home. All of these can lead to accidental falls landing a person not only on the ground, but often also in hospital.

Unintentional falls are the most common form of injury across the country: every day last year, falls resulted in almost 1,800 reported emergency department visits and 417 hospital admissions, says a new report by the Canadian Institute for Health Information (CIHI).

In 2016-17, nearly 654,000 or about one-third of the more than two million injury-related emergency department visits were due to accidental falls, CIHI reported Thursday. Injuries from falls led to about 152,500 hospital admissions, up from more than 146,600 the previous year.

The average length of a hospital stay after a fall was 14.3 days, compared to 7.5 days for other medical reasons, the data showed.

Falls are the scourge of growing older, said Geoff Fernie, a senior researcher at the Toronto Rehabilitation Institute (TRI) who is independent of CIHI. He notes that seniors have a higher risk of taking a fall and tend to have more serious injuries as a result.

"But it's not exclusively older people," he said. "We see a lot of young children falling down stairs and having serious head injuries.

"We see middle-aged people running up and down stairs and having indoor stair accidents quite commonly. And we see a lot of workers having falls and not just construction-type workers. People in the winter, people working in coffee shops and falling over in the car park when they get there in the morning."

In fact, almost 8,800 of fall-related injuries across Canada occurred as a result of people slipping on ice, CIHI data showed.

Falls within the home accounted for more than 114,000 emergency department visits last year, making it the most common place that people take a tumble.

"You keep seeing the incidence of falls going up and you see the injuries continuing to increase," said Fernie, who has been researching falls and ways to prevent them for 30 to 40 years.

CIHI found hip fractures were the most common injury sustained in falls.

"The ones that we most worry about are hips because they're extremely common and they are really difficult to get over if you're an older person," said Fernie, noting that studies have shown that between 20 and 40 per cent of seniors who break a hip die within a year.

CIHI found the second most common injuries were lower leg fractures including 16,135 broken ankles and head injuries (13,997).

"Head injuries are a big worry, too, because they can be very serious," said Fernie. "You can have long-standing effects from head injuries and people can be off work for one to two years and become quite significantly affected."

Maintaining fitness level key

Toronto Rehab runs a falls prevention program, primarily for seniors and those with disabling injuries or illness.

But researchers are also looking at ways to prevent falls at the "environmental" level, including helping to increase the depth of stair treads under the Canada Building Code, a move that was shown to save an estimated 27 lives and avoid 13,000 serious accidents in the first five years, he said.

Toronto Rehab scientists also began rating the safety of snow boots sold in Canada in 2016 (ratemytreads.com), resulting in some manufacturers improving their footwear and some retailers saying they would stock only winter boots given positive ratings for non-skid properties.

When it comes to preventing a fall, Fernie advises people, especially seniors, to maintain their fitness level to promote good balance and to keep muscles strong.

Wearing the right footwear is important, as is making sure steps and stairs in one's home are in good condition and have decent handrails on both sides. Grab bars in bathrooms can also prevent falls.

Fernie said when he gives talks on falls, about a third of the audience will raise their hands when asked if they have a close relative who has taken a spill and been injured.

But those who have not personally encountered a slip, trip or stumble tend to discount their potential seriousness, he said.

"We all think of cancer and heart disease and strokes as being the big problem they are serious and you do sometimes die of them but you also find that falls are extremely common and although they don't usually kill you straight away, sometimes they do."