Disparities in fall mortality among hypertensive older adults: An epidemiological analysis of geographic and gender differences (2026)

Type of publication:

Conference abstract

Author(s):

Sarfraz M.R.; Mushtaq I.; *Ali A.; Anwar S.; Ikram F.; Hemida M.F.; Ajaz S.

Citation:

Age and Ageing. Conference: British Geriatrics Society Autumn Meeting 2025. Nottingham United Kingdom. 55(Supplement 1) (pp i32-i33), 2026. Date of Publication: 01 Feb 2026.

Abstract:

Introduction: Falls are a leading cause of death in older adults, with hypertension (HTN) potentially increasing this risk. However, trends in fall-related mortality with co-existing HTN remain understudied. We hypothesise an increasing trend in fall-related mortality among older adults with HTN, with disparities by sex, region, and place of death.
Method(s): A retrospective analysis of adults >=65 years was conducted using CDC WONDER (1999-2023). Age-adjusted mortality rates (AAMRs) per 100,000 were stratified by sex, region, and place of death. Trends were assessed using annual and average percentage change (APC & AAPC).
Result(s): From 1999 to 2023, 215,214 fall-related deaths with co-existing hypertension were recorded, showing a significant increasing mortality trend (p<0.000001).Males had higher mortality than females (20.39 vs. 17.13 per 100,000), with significant AAPCs of 11.24% and 10.57%, respectively. In males, AAMRs rose from 2.93 in 1999 to 42.59 in 2023, with sharp increases from 1999-2001 (APC: 45.19%) and 2018-2021 (APC: 13.56%). Females showed a similar trend, rising from 2.87 to 35.57, with notable spikes in the same periods (APC: 42.44% and 13.43%).Most deaths occurred in medical facilities (52.84%), followed by nursing homes (19.09%), hospices (12.99%), and homes (10.86%). Regionally, the Midwest had the highest AAMR (22.88), followed by the West (18.58), South (18.15), and Northeast (14.11), with corresponding AAPCs of 10.81%, 8.68%, 11.45%, and 10.86%.
Conclusion(s): Mortality rates among older adults has risen significantly over the past two decades, with consistently higher rates in males and marked regional disparities. The predominance of deaths in medical and long-term care facilities underscores the need for enhanced fall-prevention strategies in these settings. Targeted interventions, particularly in high-burden regions like the Midwest and sex-specific approaches are essential to mitigate this growing public health concern.

DOI: 10.1093/ageing/afaf368.115

Introducing a falls trolley to ward 28 (2025)

Type of publication:

Service improvement case study

Author(s):

*Karen Forrest; *Debbie Pearce

Citation:

SaTH Improvement Hub, June 2025

SMART Aim:

To reduce the number of falls on ward 28 by 10% by the end of April 2025. Ward 28 aimed to increase their compliance with neurological observations to 100% by April 2025.

    Link to PDF poster

    Trial of Decaffeinated Drinks on Ward 25 (2025)

    Type of publication:

    Service improvement case study

    Author(s):

    *Clare Walsgrove; *Lynette Williams; *Mandie Esp; *Mandy Leverington; *Gill Joseph

    Citation:

    SaTH Improvement Hub, May 2025

    SMART Aim:

    To reduce the number of falls on Ward 25 at Royal Shrewsbury Hospital By 15% by 31st March 2025.

    Link to PDF poster

    Lying and Standing Blood Pressure on Ward 28 at RSH (2025)

    Type of publication:

    Service improvement case study

    Author(s):

    *Dr Radhi Al-Shaharli

    Citation:

    SaTH Improvement Hub, April 2025

    SMART Aim:

    I am aiming to:

    • Reduce the number of falls on Ward 28
    • Improve the proportion of Lying and Standard Observations undertaken both
      pre and post fall

    By May 2024

    Link to PDF poster

    Introducing a falls trolley to ward 8 (2023)

    Type of publication:

    Service improvement case study

    Author(s):

    *Lucy Roberts and *Gemma Styles

    Citation:

    SaTH Improvement Hub, December 2023

    SMART Aim:

    The overall PSIRF aim for the Trust is to reduce the number of falls with harm. Ward 8 aimed to increase their compliance with neurological observations to 100%

    Link to PDF poster

    Improving In-Hospital Falls Management Through In-situ Simulation (2024)

    Type of publication:

    Conference abstract

    Author(s):

    *Claire Swindell, *Omar Hassouba

    Citation:

    Journal of Healthcare Simulation 2024;4(Suppl 1):A1–A102

    Abstract:

    Introduction: This quality improvement initiative focuses on utilising in-situ simulation techniques to promote active participation from the multidisciplinary healthcare team to improve in-patient falls management. The project focused on a simulated patient that had sustained a fractured neck of Femur after experiencing a fall on the ward. Safe transfer of the fallen patient and identification of equipment needed was central to the project’s objectives. In doing so, learner centred engagement assisted in the identification of organisational and systematic barriers that impinge on best practice. As in-situ simulation can proactively identify latent system issues that may be acting as barriers in achieving best practice, how effective can it be in improving staff management, in response to a fallen in-patient that has sustained a Fractured neck of Femur? Methods: A collaborative approach was initiated and fostered to allow key stakeholders to identify fall-related issues and areas most in need of improvement within the Trust relating to falls. Using in-situ simulation, a standardised patient was utilised to recreate a realistic scenario, where a patient falls on the way to the toilet. The standardised patient ‘role plays’ that they have sustained a hip injury which presents as a fractured neck of femur, hence unable to get up from the floor. The multidisciplinary ward team were then observed to see how they collectively managed the fallen patient and how they safely transfer the patient from the floor. A protected, inclusive debrief was then carried out to enhance understanding of the scenario undertaken and to highlight barriers encountered. Results: Although the multidisciplinary team appeared to have a good awareness of Trust policy and procedure pertaining to post-fall care, accessibility to essential equipment needed was lacking. A need for staff training in the safe use of this essential equipment was apparent. Discussion: By carrying out this immersive in-situ simulation, specific ward issues that required attention were identified, problems that may have gone unnoticed if not presented in a realistic scenario, recreating real-time patient care needs. Therefore, in-situ simulation is an ideal and effective modality in capturing authentic latent issues that may occur during the management of a fallen patient that has sustained a fractured neck of femur. The need for improvements were identified and cascaded to the relevant teams to remove barriers for best practice.

    Link to PDF poster

    Neurological Observations (2022)

    Type of publication:
    Service improvement case study

    Author(s):
    *Clare Walsgrove, *Leeanne Morgan, *Ward Managers

    Citation:
    SaTH Improvement Hub, May 2022

    SMART Aim:
    In order to maintain the overall health of our patients, it is important to monitor patients at risk of falls and the post fall care received.

    Link to PDF poster [no password required]