Characteristics of fall-related deaths in community settings: A 5-year study

Objective: To investigate the demographic and clinical characteristics of fall-related deaths in Chinese communities and provide clinical insights for fall prevention strategies. Methods: A retrospective study was conducted on decedents (n = 1455) from a deeply aging urban community (Kaiyuan, Quanzhou, China) between 2020 and 2024. Fall-related deaths were identified by screening death certificates for specific keywords, with confirmation documented in the cause of death. Demographic, clinical, and temporal trend analyses were conducted. Kaplan-Meier and multivariate Cox proportional hazards regression were used to identify factors associated with survival time from fall to death. Results: Fall-related deaths constituted 5.5% of community deaths, predominantly affecting individuals aged ⩾60 years (93.8%). Significant gender differences were observed in marital status, occupation, and education level (all p < 0.05). Age-standardized mortality rates fluctuated from 9.17 to 16.29 per 100,000 population (2020–2024) with no significant temporal trend (Z = 0.490, p = 0.624). Univariate survival analysis revealed a notably shorter median survival in patients with comorbidities (1.0 vs. 6.0 months, p = 0.116). Multivariate analysis identified age of fall (Hazard ratio (HR) = 1.023, 95% Confidence interval (CI): 1.001–1.046, p = 0.044) and comorbidities (HR = 1.793, 95% CI: 1.022–3.147, p = 0.042) as independent predictors of shorter survival. Conclusion: Fall-related mortality is a major public health issue among older adults in the community. Advanced age of fall and comorbidities are key factors independently associated with shorter post-fall survival. Evidence-based multidimensional prevention and management interventions are essential to alleviate the fatal burden of falls.