Background The WHO reports that elderly people have the highest risk of death or serious injury arising from a fall (WHO, 2021). This study utilized the 2020 National Inpatient Sample (NIS) database from the Healthcare Cost and Utilization Project to determine which diagnostic conditions were most likely to be seen in elderly fall patients.

Methods The 2020 NIS database was used to identify the ICD-10 diagnostic codes in elderly patients that were associated with a fall code. Analyses used the first 3 digits of the diagnostic code.

Results Analyses revealed that 4.7% of the in-patient sample (6,471,165 patients) had a diagnostic fall code. We referred to these patients as falls patients (FPs). The incidence of falls increased dramatically with age, as 7.6% of patients >50 years of age (YOA) and 12.2% of patients >70 YOA were FPs. Moreover, 90.6% of the FPs were >50 YOA. As expected, 90.2% of the FPs also had a code for a musculoskeletal disorder or injury. Interestingly, 26.2% of FPs >50 YOA were associated with dementia or a neurodegenerative disorder resulting in dementia. The most common diagnostic categories seen in FPs >50 YOA were Circulatory (88.6% of patients), Psychiatric (55.6%), Neural (48.1%), and Heme/Immune diagnoses (47.1%). Interestingly, 73.1% of FPs >50 YOA had either a Psychiatric or Neural code. The highest percentage of Circulatory codes seen in FPs >50 YOA were Hypertension (44.1%), Atrial fibrillation (26.4%), Chronic heart disease (26.2%), Hypertensive chronic heart/kidney disease (22.7%), Heart failure (22.0%), and Hypotension (10.5%). The highest percentage of Psychiatric codes seen in FPs >50 YOA were Dementias (22.4%), Depression (15.8%), Anxiety (15.6%), Nicotine dependence (12.5%), and Alcohol abuse (8.2%). The highest percentage of Neural codes seen in FPs >50 YOA were Metabolic encephalopathy (12.3%), Chronic pain (11.3%), Insomnia (10.8%), Epilepsy (4.91%), Alzheimer’s (4.4%), and Parkinson’s (3.42%).

Conclusion As expected Circulatory codes were common in the FPs >50 YOA, as the incidence of these diagnoses increases dramatically with age. It was, however, surprising to see the high incidence (73.1%) of Psychiatric and Neural codes in the FPs >50 YOA, particularly codes relating to dementias. It is important to note that it was impossible in this study to determine if any falls occurred in the hospital, although we presume that most falls occurred outside of the hospital and may have been associated with hospital admission. Studies like this may help to develop fall prevention strategies by isolating specific diagnostic patient profiles in the elderly.