Citation

Miró O, 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, Martín-Sánchez FJ. Emergencias 2018; 30(4): 231-240.

Vernacular Title

Perfil de los pacientes ancianos atendidos en urgencias por caídas (Registro FALL-ER): magnitud del problema y posibilidades de mejora en los servicios de urgencias hospitalarios.

Affiliation

Servicio de Urgencias, Hospital Clínico San Carlos, Madrid, España. Facultad de Medicina de la Universidad Complutense, Madrid, España. 1Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, España.

Copyright

(Copyright © 2018, SEMES - Sociedad Española de Medicina de Urgencias y Emergencias)

DOI

unavailable

PMID

30033696

Abstract

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.

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Keywords

Emergency health services; Aged; Anciano; Caída; Falls; Geriatrics; Geriatría; Prevención; Prevention; Servicios de urgencias