Fall Mortality and Related Medical Conditions in the Elderly: The Association with Pulmonary Embolism

To investigate whether selected medical conditions increase an older person's risk of fall mortality, we analyzed 1985 multiple-cause-of-death data for persons aged 65 years or older. The 8,713 cases had a fall listed as the underlying cause of death; the 1,438,872 controls all had noninjury causes of death. Pulmonary embolism, syncope, and alcohol dependence syndrome were all strongly associated with fall deaths (prevalence odds ratio; POR = 11.7, 11.9, and 7.7, respectively). Osteoporosis, Alzheimer's disease, Parkinson's disease, senile dementia, and acute myocardial infarction were moderately associated. The prevalence odds ratios for pulmonary embolism were greater for females than for males, and increased with age. Cases were more likely to have had a pulmonary embolism if they had a fracture of the femoral neck (prevalence odds ratio; 21.0), or other lower limb fracture. Unlike the other medical conditions studied, pulmonary embolism is likely to be a sequela rather than a precursor of a fall-related injury, and, thus, is potentially preventable after hospitalization.