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Fatal Hip Fractures From Accidental Falls From a Ground-Level Fall
Christopher A. Taylor, Susan F. Ely, James Ritchie Gill. Academic Forensic Pathology, 2025-04-13
Topic: Risk, prevention and care in population studies
Accidental femur fractures in older adults are a public health concern with a considerably high rate of mortality and morbidity. We performed a retrospective review of all deaths reported to the Connecticut Office of Chief Medical Examiner (OCME) over a 5-year period that involved a femur fracture resulting from a ground-level fall. Data on cause of death, contributing conditions, age, ethnicity, sex, comorbidities, and interval between surgery and death were extracted. There were 470 deaths caused by a hip fracture due to a ground-level fall. The majority were woman ( n = 312 or 66.1%) and White ( n = 435 or 95.8%). The median age of the study population was 89 years (interquartile range [IQR] = 83-94). The locations of the falls were predominantly in homes (59.8%) or skilled nursing facilities (SNFs) (26.8%). Complications following surgery occurred with 259 (87.2%) of the 297 patients who underwent surgical repair. Contributing conditions to death occurred in 76.1% of patients ( n = 359), with the most common being heart disease, dementia, chronic obstructive pulmonary, and diabetes mellitus (DM). The median survival interval after injury was 9 days (IQR = 4-21 days). The Area Deprivation Index (ADI) was not associated with sex, race, medical conditions determined to have contributed to death, whether the patient underwent surgery, or with any surgical complication. This study demonstrates the important role of medicolegal death investigation in producing accurate death certifications that can inform stakeholders about risk factors and comorbidities that may enhance the overall management of hip fractures in an ageing population.
Key findings
- The Area Deprivation Index (ADI) was not associated with sex, race, medical conditions determined to have contributed to death, whether the patient underwent surgery, or with any surgical complication.
- This study demonstrates the important role of medicolegal death investigation in producing accurate death certifications that can inform stakeholders about risk factors and comorbidities that may enhance the overall management of hip fractures in an ageing population.
Why it matters
This review of 470 deaths from hip fractures caused by ground-level falls found that dementia was among the most common conditions contributing to death. It shows the importance of accurate death certification to inform stakeholders about risk factors and comorbidities that may improve management of hip fractures in an ageing population.
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Study details
- Participants312
- Effect sizeor 66.1; or 95.8; 59.8%
- Evidence strengthLow
How this study scored 38/100
Published in a peer-reviewed journal. Scored zero for study design and randomised / blinded because the record does not state it. We have no data on institution's track record, so that was left out: it earned 37 of the 97 points we could judge it on, which is 38 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Academic Forensic Pathology) |
| Journal's citation record | 0 / 4 | Academic Forensic Pathology: journal h-index 30 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 2 / 4 | 312 participants |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 1 / 7 | Cited 1 times (OpenAlex, 2026-10-10) |
| Citations per year | 0 / 5 | 0.3 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 1 / 6 | Cited 0.9× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 0 / 4 | Cited 1 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author James R. Gill: h-index 28 (OpenAlex, whole career) |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | 0 / 3 | OpenAlex lists 0 institution(s) in 0 countries — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 40236515) |
| Free to read | 2 / 2 | Free to read |
| Points | 37 / 97 | Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 37 of the 97 points we could judge it on is 38 out of 100. |
| Total | 38 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Taylor, C. A., Ely, S. F., & Gill, J. R. (2025). Fatal Hip Fractures From Accidental Falls From a Ground-Level Fall. Academic Forensic Pathology. https://doi.org/10.1177/19253621251333173
Vancouver
Taylor CA, Ely SF, Gill JR. Fatal Hip Fractures From Accidental Falls From a Ground-Level Fall. Academic Forensic Pathology. 2025. doi:10.1177/19253621251333173. PMID: 40236515.
BibTeX
@article{taylor2025-40236515,
author = {Taylor, Christopher A. and Ely, Susan F. and Gill, James Ritchie},
title = {{Fatal Hip Fractures From Accidental Falls From a Ground-Level Fall}},
journal = {Academic Forensic Pathology},
year = {2025},
doi = {10.1177/19253621251333173},
pmid = {40236515},
url = {https://doi.org/10.1177/19253621251333173}
}
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