NEWS POST: Infections Most Common Reason For Falls, Especially Among Elderly – Study

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People who end up in an emergency room following a fall most likely lost their balance due to an infection, not poor eyesight or tripping hazards alone, according to new research.

Blood, urinary, and respiratory infections are the most common reasons someone, especially an elderly person, falls, according to a new study released by the Massachusetts General Hospital in Boston. Many falls that put someone in an emergency room are blamed on a loose rug or bad vision, the researchers said.

"Over the years I've been struck by the fact that some of the more serious infections I treated were in people who came to the hospital because they fell," said Farrin A. Manian, MD, lead investigator of the study and a clinician educator in the Division of General Medicine at Massachusetts General Hospital. "Even though many of the patients had vague early signs of an infection, such as weakness, or lethargy, it was the fall that brought them in."

The researchers found that infections also cause younger people to take falls that lead them to a hospital: 20 percent of 161 patients involved in the study were under the age of 65. All patients had fallen, ended up in an emergency room, and then were diagnosed with a "coexisting infection."

"Of those, 71 (44.1 percent) had a urinary tract infection, 64 (39.8 percent) had a bloodstream infection, 37 (23.0 percent) had a respiratory infection and 9 (5.6 percent) had an infection of the heart valve," according to a press release on the study.

More than 40 percent of patients were not suspected of having a coexisting infection because the majority had one or none of common indicators of such a condition, including fever or rapid heart rate.

As many as 45 percent of such falls are ultimately caused by infection, according to past research cited by the study. Infections can trigger low blood pressure, which can lead to dizziness and disorientation, or also sow confusion among those with dementia, the researchers said.

"Ultimately, we hope that the public can also become more attentive to subtle signs of infections in some patients, the elderly in particular, so that perhaps these infections can be diagnosed and treated before the fall actually occurs," Manian told The Washington Post (SEE BELOW).

The study was presented Friday at IDWeek, an annual meeting concerning infectious diseases.

About 2.5 million elderly persons end up in American emergency rooms each year as a result of falls, according to the US Centers for Disease Control and Prevention, with less than a third of them requiring hospitalization. The death rate of these falls has increased, from 41 deaths per year for every 100,000 falls to 57 deaths between 2004 and 2013.

Blame The ‘Bug,’ Not The Rug. The Surprising Reason Why Some People Fall.

(iStock)

Every year, more than two million seniors wind up in the emergency room because they fell. And one out of five falls results in a serious injury, such as broken bones or a head injury.

Most falls are blamed on risk factors such as medications that can affect balance, vision problems, and throw rugs that can be tripping hazards.

But researchers now suggest that clinicians, family members and caregivers consider another offender: infections.

Bloodstream, urinary and respiratory infections are the most common culprits for infection-related falls, according to a study presented Friday in San Diego at an annual meeting on infectious diseases known as IDWeek.

The findings by researchers at the Massachusetts General Hospital in Boston also suggest that while these falls may be more common among those 65 and older, they shouldn't be overlooked in younger people: 20 percent of patients in the study were younger than 65.

Many people, including family members, caregivers and even some clinicians, don't recognize the connection. People can fall because an infection may cause low blood pressure and make someone feel lightheaded or dizzy, or because it adds to confusion in older patients with dementia, according to the researchers.

Farrin A. Manian, a clinician educator at Massachusetts General Hospital and the study's principal investigator, said in an e-mail that he hoped the study could increase awareness of falls as "being a potential manifestation of an infection" for both the public and health-care workers.

"Ultimately, we hope that the public can also become more attentive to subtle signs of infections in some patients, the elderly in particular, so that perhaps these infections can be diagnosed and treated before the fall actually occurs," he said.

(CDC/Wisqars)

Researchers analyzed 161 patients who went to the emergency room at Massachusetts General Hospital because they fell and were subsequently diagnosed with a coexisting infection. Clinicians did not initially suspect infection in 41 percent of the patients because the majority had few, if any, obvious signs, such as fever.

"Over the years I've been struck by the fact that some of the more serious infections I treated were in people who came to the hospital because they fell," Manian said. "Even though many of the patients had vague early signs of an infection, such as weakness, or lethargy, it was the fall that brought them in."
There has been previous research about the association of infections with falls, but those focused primarily in the elderly with dementia and urinary tract infections or people who lived in institutions, he said. The new study is the first to systematically look at the relationship between infections and falls in a general population. Nearly 80 percent of the patients in the study were living at home.