Falls Among Older Adults in Türkiye: A Nationwide Analysis of Emergency Medical Service Data

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Background/Objectives: Many ambulance-attended falls among older adults are not represented in hospital-based datasets. We used emergency medical service (EMS) records to describe residential and non-residential falls and identify factors associated with non-residential fall location and hospital transfer. Methods: We retrospectively analyzed records from Türkiye’s 112 EMS system from January 2023 through October 2025. The analytic sample comprised 685,666 records; no age-eligible records were excluded for missing study variables. Fall-location associations were examined using chi-square tests, Cramér’s V, and multivariable logistic regression; a multivariable model examined hospital transfer. Results: Residential falls accounted for 406,183 records (59.2%), increasing from 49.6% at ages 65–74 to 61.9% at 75–84 and 71.1% at ≥85 years, and occurring more often among women than men (65.4% vs. 50.8%). Adjusted odds ratios (ORs) for non-residential location were higher for daytime occurrence (08:00–16:59: OR = 2.871) and male sex (OR = 1.761) and lower with advancing age (≥85 years: OR = 0.424). Hospital transfer occurred in 527,881 records (77.0%). Adjusted odds were higher for yellow-coded (OR = 11.063) and red-coded (OR = 8.053) cases, lower for non-residential location (OR = 0.268) and age ≥ 85 years (OR = 0.739), and higher outside Istanbul (OR = 1.999). Conclusions: This is the first nationwide prehospital analysis of falls among older adults in Türkiye. Residential falls predominated, while fall location and hospital transfer showed demographic, temporal, triage, and geographic associations. These findings may inform research on fall prevention, prehospital assessment, and referral pathways.

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