Article Text

Download PDFPDF
Stair-related falls in the USA: traumatic brain injury and the role of alcohol intoxication
  1. Bart Hammig,
  2. Sydney Haldeman
  1. Public Health, University of Arkansas Fayetteville, Fayetteville, Arkansas, USA
  1. Correspondence to Professor Bart Hammig, Community Health Promotion, University of Arkansas Fayetteville, Fayetteville, AR 72701, USA; bhammig{at}


Introduction Falls are a leading cause of head injury in the USA. Stair-related fall injuries are common and often more serious than same level falls. Alcohol is a known contributor to unintentional injuries, and often associated with fall-related injuries, specifically falls occurring on stairs. The objective was to examine the association between alcohol use and head injuries (traumatic brain injuries (TBIs) or craniomaxillofacial (CMF) injuries) among persons aged 15–64 presenting to an emergency department (ED) with an injury resulting from a fall on stairs.

Methods Using the 2019 National Electronic Injury Surveillance System, US ED records were examined. Injuries due to falling on stairs were retrieved, with the role of alcohol in the outcome of TBI and CMF injuries examined. Prevalence ratios (PR), adjusted for covariates (blood alcohol level screening, patient demographics, drug use, disposition) were obtained from average marginal predictions derived from logistic regression models.

Results An estimated 687 902 patient visits related to falls on stairs occurred during the study period. Patients who presented with alcohol intoxication had a higher prevalence of TBI (PR 2.7 95% CI 2.3 to 3.1) and CMF injuries (PR 2.5; 95% CI 2.3 to 2.8). PRs were more pronounced among patients with blood alcohol concentration ≥0.1, as was hospital admission.

Conclusions Stair-related falls represent a common cause of ED visits for falls in the USA. Alcohol intoxication had a detrimental effect on the prevalence of TBI and CMF. A multimodal treatment approach may be beneficial given the complex interrelationship between the injury type and alcohol.

  • epidemiology
  • accidents
  • substance abuse

Data availability statement

Data are available in a public, open access repository. Numerical data are publicly for download at with no condition of reuse.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Data availability statement

Data are available in a public, open access repository. Numerical data are publicly for download at with no condition of reuse.

View Full Text


  • Contributors BH devised the study, conducted analyses and wrote portions of all sections; SH wrote portions of the introduction and discussion, aided in analyses. BH is the guarantor of the study.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.