Profile of older patients attended in the emergency department after falls: a FALL-ER registry study of the magnitude of the problem and opportunities for improving hospital emergency care.
Por:
Miró Ò, Nayla Brizzi B, Aguiló S, Alemany X, Jacob J, Llorens P, Herrero Puente P, González Ramón B, Castro Jiménez V, Torres Machado V, Cenjor R, Gil A, Rico V, Martínez Nadal G, Lázaro Del Nogal M and Martín-Sánchez FJ
Publicada:
1 ene 2018
Categoría:
Emergency medicine
Resumen:
OBJECTIVES: To profile patients aged 65 years or older who are attended in a hospital emergency department after falls. To describe the falls, their severity, and factors relevant to recommended preventive measures. MATERIAL AND METHODS: The FALL-ER is a multipurpose, multicenter prospective registry of a systematically described cohort of patients aged 65 years or older attended in 5 hospital emergency departments on 52 days of the same year. We collected data on 68 independent variables. Patients were classified according to whether they had received recommendations related to preventing falls in any of the following categories: exercise, education on fall prevention, referral to a specialist or changes in medication. RESULTS: . A total of 1507 patients or carers were interviewed (93.6% of the 1610 patients in the registry). The cohort was of advanced age and had high rates of comorbidity, polypharmacy, and history of geriatric syndromes. The majority of falls occurred during the day and in the patients home. Half the falls were not witnessed. Forty-eight percent of the patients reported fear of falling, 22% had acute functional impairment, 16% were admitted, and 0.6% died in the hospital. Recommendations directed to preventing falls were received by 509 (33.8%) cases. Loss of hearing acuity, self-reported cognitive impairment, emergency first aid at the site of the fall, fear of falling again, acute functional impairment, and hospitalization were associated with a greater likelihood of receiving recommendations for preventing falls. Loss of visual acuity was associated with a lower likelihood of receiving recommendations. CONCLUSION: Only a third of elderly patients attended in an emergency department after falls receive recommendations that target preventing further falls. Certain patient and fall characteristics are associated with a greater likelihood of receiving such recommendations.
Filiaciones:
Miró Ò:
Área de Urgencias, Hospital Clínic, Barcelona, España. Universitat de Barcelona, Barcelona, España
Nayla Brizzi B:
Servicio de Urgencias, Hospital Clínico San Carlos, Madrid, España
Aguiló S:
Área de Urgencias, Hospital Clínic, Barcelona, España
Alemany X:
Área de Urgencias, Hospital Clínic, Barcelona, España
Jacob J:
Servicio de Urgencias. Hospital de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España
:
Servicio de Urgencias, Corta Estancia y Hospitalización a Domicilio, Hospital Universitario General de Alicante, España. Universidad Miguel Hernández, Elche, Alicante, España
Herrero Puente P:
Servicio de Urgencias. Hospital Central de Asturias, España. Instituto de Investigación Sanitaria del Principado de Asturias, Asturias, España
González Ramón B:
Servicio de Urgencias, Hospital Clínico San Carlos, Madrid, España
Castro Jiménez V:
Servicio de Urgencias, Hospital Clínico San Carlos, Madrid, España
Torres Machado V:
Servicio de Urgencias. Hospital de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España
Cenjor R:
Servicio de Urgencias. Hospital Central de Asturias, España
:
Servicio de Urgencias, Corta Estancia y Hospitalización a Domicilio, Hospital Universitario General de Alicante, España
Rico V:
Área de Urgencias, Hospital Clínic, Barcelona, España
Martínez Nadal G:
Área de Urgencias, Hospital Clínic, Barcelona, España
Lázaro Del Nogal M:
Unidad de Caídas. Servicio de Geriatría del Hospital Clínico San Carlos. Madrid, España. Facultad de Medicina de la Universidad Complutense, Madrid, España
Martín-Sánchez FJ:
Servicio de Urgencias, Hospital Clínico San Carlos, Madrid, España. Facultad de Medicina de la Universidad Complutense, Madrid, España. Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, España
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