Trends and Epidemiology of Fall-Related Hospitalizations Among Older Adults in the Split-Dalmatia County, Croatia: A Retrospective Descriptive Study from 2020 to 2024.

Background and Objectives: Falls represent a major public health concern among older adults, contributing substantially to morbidity, mortality, and healthcare burden. This study aimed to analyze trends, demographic characteristics, hospitalization rates, injury patterns, and outcomes of fall-related hospitalizations among individuals aged ≥65 years in Split-Dalmatia County, Croatia, from 2020 to 2024. Materials and Methods: A retrospective epidemiological study was conducted using fall-related hospitalization data from the National Health Information System. Discharges for injury (S00-T98) caused by a fall (W00-W19) were selected using ICD-10. Analyses included individuals aged ≥65 years and were stratified by age group (65-74, 75-84, ≥85 years), sex, and year. Hospitalization rates per 100,000 population were calculated using official population data. Differences were assessed using chi-square and Kruskal-Wallis tests, while Poisson regression was used to estimate rate ratios (RRs) with 95% confidence intervals (CIs) and assess temporal trends. Results: A total of 4737 fall-related hospitalizations were recorded among individuals aged ≥65 years (58.32% of all cases). Hospitalization rates increased markedly with age, with individuals aged ≥85 years having more than a fivefold higher rate compared to those aged 65-74 years (RR = 5.16, 95% CI 4.80-5.56). Women accounted for 69.83% of cases and had higher hospitalization rates than men (RR = 1.74, 95% CI 1.64-1.85). Hip and femur injuries were the most common (50.39%). In-hospital mortality was 3.02% and higher among men. No significant temporal trend was observed (AAPC = -2.18%, p = 0.392). Conclusions: Fall-related hospitalizations are strongly associated with advanced age and female sex, with hip fractures predominating. Although rates remained stable over time, ongoing population ageing is likely to increase the future burden. Targeted, age- and sex-specific prevention strategies should be prioritized.