INTRODUCTION: When elderly people are admitted to hospital, their risk of falling may often not be recognised. The risk of falling in the elderly is linked to frailty. In a Danish study, it was found that the "Identification of Seniors at Risk" screen (ISAR) predicted the patients' amount of health problems, days in hospital and readmission. It may therefore also be a predictor of frailty. This study aimed to evaluate how many elderly patients were admitted to an emergency department (ED) because of a fall and to examine if there was a correlation between these patients and their ISAR score. METHODS: A descriptive cohort study was conducted including patients aged 65 years or older admitted to the ED, n = 198. The following data were collected: ISAR screen, cause of admittance. Furthermore, a retrospective journal review was performed by a specialist in geriatrics. RESULTS: Prior to admission, 31% had experienced a fall. Of those, 67% were not referred for further fall assessment. Patients who had experienced falls had more health problems than patients without falls (mean 5.7 versus mean 4.4 (p = 0.00)) and more had cognitive impairment (31% versus 14% (p = 0.00)). A positive correlation was found between patients' ISAR score and falls (p = 0.03). CONCLUSION: To prevent further falls and readmissions, it is crucial not only to focus on elderly people's presenting problems, but also on their dizziness and falls, especially in cognitively impaired elderly patients, and to make a plan for further assessment and follow-up. We suggest the ISAR screen as a supplement to measurement of vital signs as it may predict frailty and falls. FUNDING: not relevant.
INTRODUCTION: When elderly people are admitted to hospital, their risk of falling may often not be recognised. The risk of falling in the elderly is linked to frailty. In a Danish study, it was found that the "Identification of Seniors at Risk" screen (ISAR) predicted the patients' amount of health problems, days in hospital and readmission. It may therefore also be a predictor of frailty. This study aimed to evaluate how many elderly patients were admitted to an emergency department (ED) because of a fall and to examine if there was a correlation between these patients and their ISAR score. METHODS: A descriptive cohort study was conducted including patients aged 65 years or older admitted to the ED, n = 198. The following data were collected: ISAR screen, cause of admittance. Furthermore, a retrospective journal review was performed by a specialist in geriatrics. RESULTS: Prior to admission, 31% had experienced a fall. Of those, 67% were not referred for further fall assessment. Patients who had experienced falls had more health problems than patients without falls (mean 5.7 versus mean 4.4 (p = 0.00)) and more had cognitive impairment (31% versus 14% (p = 0.00)). A positive correlation was found between patients' ISAR score and falls (p = 0.03). CONCLUSION: To prevent further falls and readmissions, it is crucial not only to focus on elderly people's presenting problems, but also on their dizziness and falls, especially in cognitively impaired elderly patients, and to make a plan for further assessment and follow-up. We suggest the ISAR screen as a supplement to measurement of vital signs as it may predict frailty and falls. FUNDING: not relevant.
Authors: Furqaan Sadiq; Vanessa L Kronzer; Troy S Wildes; Sherry L McKinnon; Anshuman Sharma; Daniel L Helsten; Lawrence M Scheier; Michael S Avidan; Arbi Ben Abdallah Journal: Anesth Analg Date: 2018-10 Impact factor: 5.108