Citation

Kartiko S, Jeremitsky E, Cripps MW, Konderwicz I, Jarosz E, Minshall CT. J. Trauma Acute Care Surg. 2019; ePub(ePub): ePub.

Affiliation

Division of Trauma/ Critical Care, Department of Surgery, University of Massachusetts-Baystate Medical Center, Springfield, MA, USA.

Copyright

(Copyright © 2019, Lippincott Williams and Wilkins)

DOI

10.1097/TA.0000000000002514

PMID

31626026

Abstract

OBJECTIVE: Falling is the most common cause of trauma in the geriatric population. To identify patients that were at-risk for falling, we implemented a provider-directed fall prevention screening initiative in the ambulatory setting of a large tertiary care referral center. We used 3 clinician-directed questions from the STEADI toolkit. Our goal was to intervene on patients who were screened as at-risk for falling by referring them to our physical therapy program and evaluating its effects to these patients.

METHOD: Patients ≥ 55 yo who live in the community were screened from 6/2017-6/2018. Patients who answered yes to any of the 3 questions were identified as at-risk for falling, and referred to the Fall Prevention Initiative Physical Therapy Program (FPIPTP). The FPIPTP is a program that establishes a quantifiable fall risk using the Time Up and Go test (TUG), which then initiates PT treatments, designed to prevent future falls by improving, gait, balance, and fitness. The Wilcoxon signed rank test was used to determine significance (p<0.05).

RESULTS: We identified 112 patients with a median age of 76.5 yo (IQR 68-82) to be at-risk for falling. The initial median TUG score in this group of patients is 15.85 sec (12-20.33), which is consistent with a high fall-risk (time > 12 sec). After completing the FPIPTP, the median TUG score significantly improved to 12sec (9-15, p<0.0001).

CONCLUSION: We conclude that a provider can use the 3 specific questions from the STEADI toolkit to identify patients (≥55 yo) that are at-risk for falling. Additionally, the FPIPTP is able to significantly improve the TUG score in this group. We will need to confirm this conclusion with a larger population study. LEVEL IV EVIDENCE: diagnostic/therapeutic study.

Language: en