Our study has shown that the incidence of fall-related injuries decreased in our setting. Fall-related injuries increased in the elderly, female population, and UAE nationals. Although falls from the same level, in-homes, and public places increased; falls from height and workplaces decreased. The severity of injuries was higher, but hospital length of stay decreased overtime. The mortality did not change.
Some countries in our region, such as Iraq, has reported an increased incidence of accidental falls . In contrast, fall-related injuries reduced overtime in our city which is similar to the global decrease . However, the Gulf region countries showed the lowest decrease (≤10%) in the incidence of fall-related injuries and shared this category with South Asian and African countries . One of the significant determinants of fall-related injuries is its location. Workplace-related falls from height are still common in our setting because of the construction demands . We think that the decrease in fall from height in the current study reflects the successful implementation of safety regulations at workplace in our setting .
Fall-related injuries in our study were mainly in males. In contrast, other studies showed higher incidence in females [21, 22]. This can be attributed to the high percentage of male expatriate manual laborers working in construction in our city. Nevertheless, and like others, fall-related injuries in females, which are mainly on the same level, has increased in our study [23, 24].
Geriatric falls is a serious public health problem . Living alone, effect of medications, movement disorders, weak sensory power, reduced mobility, and arthritis are risk factors for falls in the elderly population even if physically active [26-28]. UAE has a fast aging population compared with the other Gulf countries . Similar to others, our study has shown that geriatric falls increased overtime which was more in females . Injury prevention and developments in the trauma system in our city reduced injuries by 38.2% and mortality by 56% in hospitalized trauma patients .
Despite the increased severity of injuries of hospitalized fall-related patients in the second period, hospital stay, and mortality were less. This can be attributed to developments in the trauma system which includes better pre-hospital field medical management, faster transfer to the hospital and better in-hospital trauma care including the emergency department, surgical interventions, and critical care.
Fall prevention programs should be properly implemented [8, 32. Despite the significant decrease in work-related fall-related injuries and fall from height in the current study, there is an urgent need to reduce falls at public areas and homes.
There are several limitations in our study. First, the data studied were from a single hospital in our city which cannot be generalized to the whole country. Nevertheless, we think that observing the preventive interventions and evaluating their effects gives a strong example to follow within our region. Second, we studied injured patients who were hospitalized for more than 24 hours or who died at the Emergency Department. Therefore, this group does not represent the whole fall-related injuries in our city as it excludes who did not present to the hospital. Third, it would have been better to have a continuous data registry through those years without interruption. This occurred because of financial restraints which is a common problem facing trauma registries. Fourth, we do not have more details on the injury incidents and their contributing factors which can give us a more in depth planning for the next prevention strategies.