Characteristics of falls, contributory factors and injury-related outcomes in older people admitted to sentinel hospitals in Sri Lanka

Introduction: Falls among older people are a major public health concern, particularly in ageing populations like Sri Lanka. Understanding falls epidemiology is crucial for falls prevention and promoting healthy ageing. Objectives: To describe the epidemiological characteristics of falls, the contributory factors and the outcomes of related injuries among those aged ≥60 years, admitted to sentinel hospitals in Sri Lanka Methods: This descriptive cross-sectional study utilised secondary data from the National Injury Surveillance System (NISS), Ministry of Health. Study population included individuals aged ≥ 60 years, admitted to hospitals nationwide due to falls between 2019-2022. Secondary data on falls, sociodemographic characteristics and injury outcomes were extracted from the NISS e-database. The proportion of falls among those ≥ 60 years was calculated by dividing the fall-related admissions by total injury admissions in the same age group. Age-specific death rates were calculated using Sri Lanka's 2012 census data. Results: Falls accounted notably to injury-related hospitalisations among older people (n=49,500), showing an increasing trend from 2019-2022. The proportion was 32.6% (95% CI: 32.1, 33.1) in 2019, 34.4% (95% CI: 33.9, 34.9) in 2020, 34.7% (95% CI: 34.1, 35.3) in 2021, and rose to 39.4% (95% CI: 38.9, 39.9) in 2022. The highest number of falls in this population was reported in the Western province of Sri Lanka. The home is the primary location for falls, accounting for 65.7% (n=32,504), with most occurring during leisure (23.3%) or household (22.1%) activities. Among elderly fall admissions, 9.5% (n=4,686) developed disabilities. Young elders (60–69 years) accounted for 45.7% (n=22,623) of fall-related hospitalisations, while those ≥ 80 years had the highest age-specific death rate (36.9 per 100,000) in 2022. Conclusions & Recommendations: Falls are a leading cause of hospitalisation and disability among older people, often occurring at home during household and leisure activities. Targeted falls prevention interventions are recommended, to ensure home safety, and age-friendly environments.