OTA International The Open Access Journal of Orthopaedic Trauma · Jul 20, 2026 · LoE III
Despite lower fracture rates, homeless patients have worse outcomes after geriatric ground-level falls: an analysis of National Trauma Data Bank
This retrospective cohort study used the National Trauma Data Bank (2021-2022) to compare outcomes after ground-level falls in 1,136 homeless versus 325,267 housed adults aged 50 and older. Despite being younger and having significantly lower fracture rates (51.2% vs 59.3%), homeless patients had worse outcomes: longer hospital stays (8.82 vs 6.63 days), more ICU admissions (25.3% vs 19.8%), and more complications (11.5% vs 6.3%), with homelessness independently associated with 1.5-fold higher odds of extended length of stay after adjusting for comorbidities and injury severity.
AI summary · from the full text
Why it mattersThis highlights that housing status is an independent driver of trauma outcomes and resource utilization, prompting orthopaedic trauma teams to consider social determinants of health in discharge planning for geriatric fall patients.
Fragility index 59 and first evidence on the question, offset by no power calculation.