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Original Research

Open Access

Risk factors for ground-level fall injuries during active activity in older patients

  • Jung Sung Hwang1
  • Sun Hyu Kim1,*,
  • Sang Cheal Lee1
  • SunPyo Kim2
  • Gyu Chong Cho3
  • Min Joung Kim4
  • Duk Hee Lee5
  • Yura Ko6

1Department of Emergency Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, 44033 Ulsan, Republic of Korea

2Department of Emergency Medicine, College of Medicine, Chosun University, 61453 Gwangju, Republic of Korea

3Department of Emergency Medicine, School of Medicine, Hallym University, 05355 Seoul, Republic of Korea

4Department of Emergency Medicine, Yonsei University College of Medicine, 03722 Seoul, Republic of Korea

5Department of Emergency Medicine, Ewha Womans University, School of Medicine, 07985 Seoul, Republic of Korea

6Department of Emergency Medicine, Ajou University School of Medicine, 16499 Suwon, Republic of Korea

DOI: 10.22514/sv.2023.099 Vol.20,Issue 2,February 2024 pp.85-95

Submitted: 21 August 2023 Accepted: 21 September 2023

Published: 08 February 2024

*Corresponding Author(s): Sun Hyu Kim E-mail:;


In older patients, ground-level falls are the most common cause of injury. Many intrinsic and extrinsic factors influence ground fall injuries. However, the characteristics and severity of ground fall injuries have not been compared according to the activity levels. We compared the characteristics of ground fall injuries by the activity level to establish a preventive strategy for ground fall injuries in older patients. We retrospectively reviewed the records of older patients who were admitted to six university hospitals for ground-level fall injuries from 2011 to 2020. The patients were classified into active and inactive groups. Active activities were defined as paid work, exercise and leisure activities. General and clinical characteristics of both groups for ground-level fall injury were analyzed. Propensity score matching analysis (1:1) was performed for baseline characteristics (sex, age and alcohol consumption). A total of 33,924 patients were enrolled, of which 4887 (14.4%) were classified in the active group. Injury severity was not different between the active and inactive groups. The main factors significantly associated with ground fall injuries during activities in elderly patients were male sex, age from 65 to 74 years and 75 to 84 years compared to greater than 85 years, an injury time other than 00:00–05:59, alcohol consumption, sloping floor and floor type other than concrete. After propensity score matching analysis, the factors associated with ground-level fall injuries in older patients when they were active were a time of injury from 06:00–17:59 compared to 00:00–05:59, slippery floor, slope, the absence of obstacles and type of floor other than concrete. We should establish preventive strategies for reducing ground-level fall injuries in older patients during activity, which could include wearing compatible footwear, caution on sloping areas, and maintenance of unpaved roads.


Ground-level fall injury; Older patient; Active; Floor; Time of injury; Severity

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Jung Sung Hwang,Sun Hyu Kim,Sang Cheal Lee,SunPyo Kim,Gyu Chong Cho,Min Joung Kim,Duk Hee Lee,Yura Ko. Risk factors for ground-level fall injuries during active activity in older patients. SignaVitae. 2024. 20(2);85-95.


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