Predictors of Hospital Admission Following Emergency Department Presentation for Falls Among Older Adults: A Retrospective Analysis

OBJECTIVE: To identify demographic, clinical and injury-related factors independently associated with hospital admission among older adults presenting to the emergency department (ED) after a fall. METHODS: We conducted a retrospective chart review of electronic medical records for 574 patients aged 65 years and older who presented to the ED of a general hospital between January and June 2023 with non-traumatic fall presentations. Data included demographics, fall circumstances, mode of arrival, comorbidities, medication exposure and ED diagnoses. Multivariable logistic regression was used to identify independent predictors of hospital admission. RESULTS: Of 574 older adults, 187 (33%) were admitted. Admission was independently associated with female sex (aOR 2.29, 95% CI 1.35-3.89), age 78 years and older and ambulance arrival. Comorbidities including hypertension, diabetes, dementia, Parkinson's disease and multimorbidity were also associated with higher odds of admission. Use of fall-risk-increasing medications remained a significant predictor. Serious injuries, particularly fractures and intracranial haemorrhage, were strongly associated with admission. CONCLUSIONS: Hospital admission after ED presentation for falls in older adults reflects both injury severity and underlying clinical vulnerability. Incorporating comorbidity burden and medication risk into ED assessment may support disposition decisions and help target secondary prevention, especially for individuals discharged directly from the ED.