TY  - JOUR
PY  - 2019//
TI  - 180-Day functional decline among older patients attending an emergency department after a fall
JO  - Maturitas
A1  - Miró, Oscar
A1  - Brizzi, Berenice N.
A1  - Aguiló, Sira
A1  - Alemany, Xavier
A1  - Jacob, Javier
A1  - Llorens, Pere
A1  - Herrero Puente, Pablo
A1  - Torres Machado, Victoria
A1  - Cenjor, Raquel
A1  - Gil, Adriana
A1  - Rico, Verònica
A1  - Álvarez Carretero, María
A1  - Cuccolini, Lucía
A1  - Martínez Nadal, Gemma
A1  - Fernández Pérez, Cristina
A1  - Lázaro del Nogal, Montserrat
A1  - Platts-Mills, Timothy F.
A1  - Martín-Sánchez, Francisco Javier
SP  - 50
EP  - 56
VL  - 129
IS  - 
N2  - OBJECTIVES: To determine functional changes and factors affecting 180-day functional prognosis among older patients attending a hospital emergency department (ED) after a fall. STUDY DESIGN: Retrospective analysis from a prospective cohort study (FALL-ER Registry) spanning one year that included individuals aged ≥65 years attending four Spanish EDs after a fall. We collected 9 baseline and 6 fall-related factors. MAIN OUTCOME MEASURES: Barthel Index (BI) was measured at baseline, discharge and 30, 90 and 180 days after the index fall. Absolute and relative BI changes were calculated. Absolute difference of ≥10 points between BI at baseline and at 180 days was considered a clinically significant functional decline. <br><br>RESULTS: 452 patients (mean age 80 ± 8 years; 70.8% women) were included. Baseline BI was 79.3 ± 23.1 points. Compared with baseline, functional status was significantly lower at the 4 follow-up time points (-8.7% at discharge; and -6.9%, -7.9% and -9.5% at 30, 90 and 180 days; p < 0.001 for all comparisons in relation to baseline; p = 0.001 for change over time). One hundred and thirty-three (29.6%) patients had a clinically significant functional decline at 180 days. Age ≥85 years (OR = 2.24, 95%CI 1.23-4.08; p = 0.008), fall-related fracture (OR = 2.45, 95%CI 1.43-4.28; p = 0.001), hospitalization (OR = 1.91; 95%CI 1.11-3.29; p = 0.019) and post-fall syndrome (OR = 1.77, 95%CI 1.13-2.77; p = 0.013) were independently associated with 180-day clinically significant functional decline. <br><br>CONCLUSION: Patients ≥65 years attending EDs after a fall experience a consistent and persistent negative impact on their functional status. Several factors may help identify patients at increased risk of functional impairment.<br><br>Copyright © 2019 Elsevier B.V. All rights reserved.<p />  <p>Language: en</p>
LA  - en
SN  - 0378-5122
UR  - http://dx.doi.org/10.1016/j.maturitas.2019.08.008
ID  - ref1
ER  -