A Retrospective Analysis of Fall Patients and the Potential Contribution of Opioids

Stephanie Adjei
Jake Muha
Jana Sanders
Annette Chard
Lisa Hollister, Parkview Health
Deborah McMahan MD

Abstract

Background: The leading cause of death due to unintentional injuries amidst individuals 65 years and older is falls, and there is increasing evidence of an association between opioid use and falls in older adults. Objective: The aim of this study was to observe the rate at which patients admitted to trauma centers had opioids listed on their current medications list or present in their urine drug screen. Methods & Design: This study conducted a retrospective, descriptive, correlational study of 2,873 patients aged 15 years and older who were admitted to Allen County trauma centers as a result of a fall between 01/01/2017 and 04/30/2018. Data regarding if the patient had an opioid or benzodiazepine medication on their current medications list and if they were discharged with an opioid were gathered via chart review. The age groups were divided into two groups to observe differences between younger and older adults. Associations were evaluated via univariate and multivariate logistic regression tests. Odds ratios (ORs) were utilized to demonstrate the results with 90% confidence intervals (90% CI). Additional sub-analyses for length of stay (LOS), patient status at time of discharge, and injury severity score (ISS) were also performed. Results: Of all the patients who were admitted to a trauma center for a fall, 30.0% had an existing opioid prescription in their medical records. Of those that had a documented opioid prescription in their current medications list, 87.2% were in the older adult age group. Overall, older adults with an opioid prescription comprised 31.2% of the total fall population (Odds Ratio [OR]=0.71; 90% CI 0.59-0.86). Conclusion: This study demonstrates that the proportion of patients on opioid medications prior to their fall may have been underestimated, compared to the previous literature.