Fall related injuries: A retrospective medical review study in North India Jagnoor Jagnoor *, Lisa Keay, Atreyi Ganguli, Rakhi Dandona, J.S. Thakur, Soufiane Boufous, Robert Cumming, Rebecca Q. Ivers The George Institute for Global Health, Injury Division, Level 7, 341 George Street, Sydney, NSW 2000, Australia Introduction Falls are the second leading cause of injury mortality worldwide. The 2004 Global Burden of Disease and Injury study estimated that 11% of all unintentional injury deaths are due to falls. 1 The million death study, a nationally representative study for cause specific mortality in India, reports 25% of all uninten- tional injuries were due to falls. 2 In absolute numbers, 160,000 deaths due to unintentional fall injuries were estimated for the year 2005; only marginally less than road traffic injury deaths (185 000) for the same year. 2 Fall injuries also lead to significant disability in the population with an estimated 375 DALYs per 100,000 population in India. 1 International research inidicates that the context, nature and severity of falls varies by age and gender. 3,4 A high fall injury prevelance is reported amongst children in low and middle income settings, and the limited literature suggests that these falls are from height. 5–7 There are very few studies which measure the incidenceon falls in India. 7,8 Whilst there is mounting evidence of the high burden of fall- related injuries in the population, there is little understanding of the context and characteristics of these falls, which is essential for appropriate prevention and injury control programmes in India. The present study therefore aims to describe the context and characteristics of fall related injury cases presenting at a tertiary care hospital of North India. Ethical considerations The study was approved by the Ethics committee of the Post Graduate Institute of Medical Education (PGIMER), India and the Human Research Ethics Committee, University of Sydney, Australia. Materials and methods Study setting The study was conducted at the Nehru Hospital, PGIMER, one of the three hospitals in Chandigarh, North India. Nehru hospital Injury, Int. J. Care Injured 43 (2012) 1996–2000 A R T I C L E I N F O Article history: Accepted 10 August 2011 Keywords: Fall Injury Context Characteristics India Nature and site of fall injury A B S T R A C T Introduction: Falls have been identified as a leading cause of injury-related morbidity and mortality in India. However, very little is known about the context and characteristics of such falls. The aim of this study was to describe the context and characteristics of fall related injuries in patients admitted to hospital for fall injury. Methods: Medical records of patients presenting at the Emergency Department of the Nehru Hospital, Chandigarh, India between March 2008 and February 2009, were reviewed by trained investigators. All injury cases were identified and fall related injury cases were assigned an ICD 10, Chapter XX, External causes of morbidity and mortality code. A review of medical records was conducted to determine the context, nature and site of injury associated with a fall event. Results: Ten percent (7049) of hospital emergency presentations were due to injuries, and falls were the second leading cause (20%, 1407). Seventy-six percent of the fall related presentations were in males. More than one third (36%) of the fall related presentations occurred in those aged 0–14 years old. Falls from building or structures (35%, 499) were the leading cause for all ages except for those older than 60 years, where same level falls due to slipping, tripping and stumbling (40%, 57) were predominant. Half of all the falls resulted in head injury. Nearly 10% of patients presenting for fall related injury died. Conclusion: Fall related injuries are an important contributor to hospital emergency presentations, particularly falls from buildings in children, and slips and trips in older people. Given the high proportion of falls that resulted in head injury and death, there is a significant need to develop appropriate interventions to prevent such falls. ß 2011 Elsevier Ltd. All rights reserved. Abbreviations: ICD, International Classification of Disease; PGIMER, Post Graduate Institute of Medical Education and Research; WHO, World Health Organisation. * Corresponding author. Tel.: +61 2 9657 0350; fax: +61 2 9657 0301. E-mail address: jjagnoor@george.org.au (J. Jagnoor). Contents lists available at ScienceDirect Injury jo ur n al ho m epag e: ww w.els evier .c om /lo cat e/inju r y 0020–1383/$ – see front matter ß 2011 Elsevier Ltd. All rights reserved. doi:10.1016/j.injury.2011.08.004