Retrospective analysis of mortality and the influence of polypharmacy in geriatric staircase falls

BACKGROUND: Staircase falls are a significant cause of emergency department visits among older adults (≥ 65 years) and are associated with increased morbidity and mortality. While previous research has explored risk factors for injury severity, the role of polypharmacy (≥ 5 regular medications) in influencing injury patterns and clinical outcomes remains unclear. METHODS: A retrospective analysis was conducted using patient records from a university hospital emergency department within a five-year observation period, with a minimum follow-up of two years. Demographic data, health status, injury patterns, and outcomes were analyzed. Survival analysis was performed to assess the impact of polypharmacy on long-term survival. RESULTS: A total of 529 patients were included, of whom 243 (45.9%) were classified as polypharmacy patients. Polypharmacy patients were significantly older (mean age 79.18 vs. 76.45 years, p < 0.001) and had higher comorbidity burdens, including increased BMI, dementia, depression, and previous falls (p < 0.05). Although polypharmacy was not significantly associated with specific injury patterns, it was linked to worse clinical outcomes. Patients with polypharmacy were more likely to require inpatient admission (70.8% vs. 62.2%) and had lower long-term survival rates (p = 0.014). After adjusting for covariates, polypharmacy remained an independent risk factor for mortality (p = 0.042). CONCLUSION: Polypharmacy is prevalent among older adults with staircase falls and is associated with increased frailty, comorbidities, and poor clinical outcomes, including higher mortality. These findings underscore the need for targeted medication management and comprehensive fall prevention strategies to improve outcomes in this vulnerable population group.