Fall-related injuries, burden & costs in Luxembourg’s older population: A nationwide analysis of emergency department (ED) visits

Introduction: In 2024, fall-related injuries accounted for +/-10%  of all hospital treatments in Luxembourg and fall-related mortality increased sharply after age 70. Beyond mortality, injuries burden individuals and healthcare systems. Aim: Estimate the age- and sex-specific differences of fall-related injuries, fractures and related hospitalisations in Luxembourg.    
Methods: Using RETRACE injury surveillance data, we analysed all 8,404 fall-related emergency department (ED) visits in 2018 of individuals ≥60 years in Luxembourg. We estimated age- and sex-specific differences of central body injuries (head, trunk, hip), fractures and hospitalisation.
Results: Females had most fall-related ED visits. Each additional y of age increased the odds of central body injuries (OR=1.04, 95%CI[1.03,1.05], p<0.001), with sex-related differences peaking around 70 and narrowing around 85 y. Head-injury-related visits increased from 22% (<70 y) to 36% (>90 y), hip-injury-related visits from 6% to 21%. Females had slightly more hip-injury-related visits (13% vs. 10%) while males had more head-injury-related visits (34% vs. 27%). The odds for fall-related hospitalisations increased per additional y (OR=1.03, 95%CI[1.02,1.04], p<0.001) and less steeply in females. Compared with non-hospitalised visits, visits leading to hospitalisation more frequently had central body injuries, particularly hip injuries (27% vs. 7% ), and fractures (49% vs. 18%). 
Conclusions: Fall-related ED visits among older adults in Luxembourg varied by sex and age, with females having more fracture-related visits and males more central-body-injury-related visits. With older age, head and hip injuries increased, as was hospitalisation following visits for central body injuries and fractures. Age-sensitive fall-injury prevention is needed to reduce fractures and avoidable hospitalisations. Our next analyses will detail sociodemographic and contextual factors, DALYs and related costs across sex and age.