Shan W Liu1, Ziad Obermeyer2, Yuchiao Chang3, Kalpana N Shankar4. 1. Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA. Electronic address: sliu1@partners.org. 2. Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA. 3. General Medicine Division, Massachusetts General Hospital, Boston, MA. 4. Department of Emergency Medicine, Boston University Medical Center, Boston, MA.
Abstract
INTRODUCTION: Falls among older adults (aged ≥65 years) are the leading cause of both injury deaths and emergency department (ED) visits for trauma. We examine the characteristics and prevalence of older adult ED fallers as well as the recurrent ED visit and mortality rate. METHODS: This was a retrospective analysis of a cohort of elderly fall patients who presented to the ED between 2005 and 2011 of 2 urban, level 1 trauma, teaching hospitals with approximately 80000 to 95000 annual visits. We examined the frequency of ED revisits and death at 3 days, 7 days, 30 days, and 1 year controlling for certain covariates. RESULTS: Our cohort included 21340 patients. The average age was 78.6 years. An increasing proportion of patients revisited the ED over the course of 1 year, ranging from 2% of patients at 3 days to 25% at 1 year. Death rates increased from 1.2% at 3 days to 15% at 1 year. A total of 10728 patients (50.2%) returned to the ED at some point during our 7-year study period, and 36% of patients had an ED revisit or death within 1 year. In multivariate logistic regression, male sex and comorbidities were associated with ED revisits and death. CONCLUSION: More than one-third of older adult ED fall patients had an ED revisit or died within 1 year. Falls are one of the geriatric syndromes that contribute to frequent ED revisits and death rates. Future research should determine whether falls increase the risk of such outcomes and how to prevent future fall and death.
INTRODUCTION: Falls among older adults (aged ≥65 years) are the leading cause of both injury deaths and emergency department (ED) visits for trauma. We examine the characteristics and prevalence of older adult ED fallers as well as the recurrent ED visit and mortality rate. METHODS: This was a retrospective analysis of a cohort of elderly fall patients who presented to the ED between 2005 and 2011 of 2 urban, level 1 trauma, teaching hospitals with approximately 80000 to 95000 annual visits. We examined the frequency of ED revisits and death at 3 days, 7 days, 30 days, and 1 year controlling for certain covariates. RESULTS: Our cohort included 21340 patients. The average age was 78.6 years. An increasing proportion of patients revisited the ED over the course of 1 year, ranging from 2% of patients at 3 days to 25% at 1 year. Death rates increased from 1.2% at 3 days to 15% at 1 year. A total of 10728 patients (50.2%) returned to the ED at some point during our 7-year study period, and 36% of patients had an ED revisit or death within 1 year. In multivariate logistic regression, male sex and comorbidities were associated with ED revisits and death. CONCLUSION: More than one-third of older adult ED fall patients had an ED revisit or died within 1 year. Falls are one of the geriatric syndromes that contribute to frequent ED revisits and death rates. Future research should determine whether falls increase the risk of such outcomes and how to prevent future fall and death.
Authors: Patricia Ayoung-Chee; Lisa McIntyre; Beth E Ebel; Christopher D Mack; Wayne McCormick; Ronald V Maier Journal: J Trauma Acute Care Surg Date: 2014-02 Impact factor: 3.313
Authors: David P Sklar; Cameron S Crandall; Eric Loeliger; Kathleen Edmunds; Ian Paul; Deborah L Helitzer Journal: Ann Emerg Med Date: 2007-01-08 Impact factor: 5.721
Authors: Gelareh Z Gabayan; Stephen F Derose; Steven M Asch; Sau Yiu; Elizabeth M Lancaster; K Trudy Poon; Jerome R Hoffman; Benjamin C Sun Journal: Ann Emerg Med Date: 2011-07-29 Impact factor: 5.721
Authors: Melissa A Russell; Keith D Hill; Lesley M Day; Irene Blackberry; Jenny Schwartz; Melita J Giummarra; Michael Dorevitch; Joseph E Ibrahim; Andrew C Dalton; Shyamali C Dharmage Journal: J Am Geriatr Soc Date: 2010-12 Impact factor: 5.562
Authors: Christopher R Carpenter; Mark D Scheatzle; Joyce A D'Antonio; Paul T Ricci; Jeffrey H Coben Journal: Acad Emerg Med Date: 2009-03 Impact factor: 3.451
Authors: Lauren T Southerland; Katherine M Hunold; Christopher R Carpenter; Jeffrey M Caterino; Lorraine C Mion Journal: Am J Emerg Med Date: 2018-12-13 Impact factor: 2.469
Authors: Arjun K Venkatesh; Hao Mei; Keith E Kocher; Michael Granovsky; Ziad Obermeyer; Erica S Spatz; Craig Rothenberg; Harlan M Krumholz; Zhenqui Lin Journal: Acad Emerg Med Date: 2017-03-17 Impact factor: 3.451
Authors: Elizabeth M Goldberg; Sarah J Marks; Aderonke Ilegbusi; Linda Resnik; Daniel H Strauss; Roland C Merchant Journal: J Am Geriatr Soc Date: 2019-10-17 Impact factor: 5.562
Authors: Nada Hammouda; Christopher R Carpenter; William W Hung; Adriane Lesser; Sylviah Nyamu; Shan Liu; Cameron J Gettel; Aaron Malsch; Edward M Castillo; Savannah Forrester; Kimberly Souffront; Samuel Vargas; Elizabeth M Goldberg Journal: Acad Emerg Med Date: 2021-06-15 Impact factor: 3.451
Authors: William S Bayliss; Cheryl D Bushnell; Jacqueline R Halladay; Pamela W Duncan; Janet K Freburger; Anna M Kucharska-Newton; Justin G Trogdon Journal: Med Care Date: 2021-02-01 Impact factor: 2.983
Authors: Kalpana Narayan Shankar; Nicole J Treadway; Alyssa A Taylor; Alan H Breaud; Elizabeth W Peterson; Jonathan Howland Journal: Inj Epidemiol Date: 2017-06-19
Authors: Peter Rasche; Alexander Mertens; Christopher Brandl; Shan Liu; Benjamin Buecking; Christopher Bliemel; Klemens Horst; Christian David Weber; Philipp Lichte; Matthias Knobe Journal: JMIR Mhealth Uhealth Date: 2018-03-27 Impact factor: 4.773