Hospital stays after falls increase the risk of death primarily because of a combination of physical, medical, and psychological factors that compound the vulnerability of patients, especially older adults. When someone falls and is hospitalized, the event often triggers a cascade of complications that can worsen their overall health and increase mortality risk.
First, the initial injury from the fall itself can be severe. Falls commonly cause fractures, head injuries, and internal bleeding, which can be life-threatening or lead to long-term disability. For example, hip fractures are notorious for causing significant morbidity and mortality in older adults. These injuries often require surgery and prolonged immobilization, which can lead to further health problems.
Once admitted to the hospital, patients face risks related to immobility. Being bedridden or less mobile increases the chance of developing complications such as blood clots (deep vein thrombosis), pneumonia, pressure ulcers (bedsores), and muscle wasting (sarcopenia). These complications can severely impair recovery and increase the risk of death. Immobility also contributes to a decline in physical function, making it harder for patients to regain independence.
Hospital environments themselves can contribute to increased risk. Older adults are particularly susceptible to hospital-acquired infections, including urinary tract infections, respiratory infections, and sepsis. These infections can be deadly, especially in patients with weakened immune systems or multiple chronic conditions. Additionally, hospitals can be disorienting, leading to delirium or confusion, which increases the risk of further falls or other accidents during the stay.
Medication changes during hospitalization can also play a role. Patients may be prescribed new drugs or have their existing medications adjusted, sometimes leading to side effects such as dizziness, low blood pressure, or sedation. These side effects can increase the risk of falls after discharge and complicate recovery.
Psychological factors are important as well. A fall and subsequent hospital stay can cause fear of falling again, anxiety, depression, and loss of confidence. This fear can lead to reduced activity levels, social isolation, and further physical decline, all of which contribute to poorer outcomes and higher mortality risk.
Moreover, many patients admitted after a fall already have underlying health issues such as chronic diseases, cognitive impairment, or frailty. These conditions make recovery more difficult and increase vulnerability to complications. The interplay of these factors means that a hospital stay after a fall is often not just about treating the injury but managing a complex set of risks that can lead to death.
In summary, hospital stays after falls increase the risk of death because the initial injury often leads to serious complications, immobility causes additional health problems, hospital environments expose patients to infections and delirium, medication changes can have adverse effects, and psychological impacts reduce recovery potential. Combined with pre-existing health conditions, these factors create a high-risk situation for patients, especially older adults.