Risk of falls is associated with 30-day mortality among older adults in the emergency department.

Accidental falls Aged Delirium Fall Fracture Frailty Injuries Major trauma Mortality Older adult Trauma

Journal

The American journal of emergency medicine
ISSN: 1532-8171
Titre abrégé: Am J Emerg Med
Pays: United States
ID NLM: 8309942

Informations de publication

Date de publication:
21 Feb 2024
Historique:
received: 19 12 2023
revised: 06 02 2024
accepted: 13 02 2024
medline: 1 3 2024
pubmed: 1 3 2024
entrez: 29 2 2024
Statut: aheadofprint

Résumé

Falls in older adults correlate with heightened morbidity and mortality. Assessing fall risk in the emergency department (ED) not only aids in identifying candidates for prevention interventions but may also offer insights into overall mortality risk. We sought to examine the link between fall risk and 30-day mortality in older ED adults. Observational cohort study of adults aged ≥ 75years who presented to an academic ED and who were assessed for fall risk using the Memorial Emergency Department Fall Risk Assessment Tool (MEDFRAT), a validated, ED-specific screening tool. The fall risk was classified as low (0-2 points), moderate (3-4 points), or high (≥5) risk. The primary outcome was 30-day mortality. Hazard ratios (HR) with 95% confidence intervals (CIs) were calculated. A total of 941 patients whose fall risk was assessed in the ED were included in the study. Median age was 83.7 years; 45.6% were male, 75.6% lived in private residences, and 62.7% were admitted. Mortality at 30 days among the high fall risk group was four times that of the low fall risk group (11.8% vs 3.1%; HR 4.00, 95% CI 2.18 to 7.34, p < 0.001). Moderate fall risk individuals had nearly double the mortality rate of the low-risk group (6.0% vs 3.1%), but the difference was not statistically significant (HR 1.98, 95% CI 0.91 to 4.32, p = 0.087). ED fall risk assessments are linked to 30-day mortality. Screening may facilitate the stratification of older adults at risk for health deterioration.

Identifiants

pubmed: 38422753
pii: S0735-6757(24)00082-2
doi: 10.1016/j.ajem.2024.02.020
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

122-126

Informations de copyright

Copyright © 2024 Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest The authors of this manuscript have no conflict of interest to disclose related to this manuscript.

Auteurs

Matthew P Hamilton (MP)

Department of Emergency Medicine, Mayo Clinic, Rochester, MN, USA.

Fernanda Bellolio (F)

Department of Emergency Medicine, Mayo Clinic, Rochester, MN, USA; Department of Medicine, Division of Community Internal Medicine, Geriatric Medicine and Palliative Care, Section of Senior Services and Geriatric Medicine, Mayo Clinic, Rochester, MN, USA; Division of Health Care Delivery Research, Mayo Clinic, Rochester, MN, USA. Electronic address: Bellolio.fernanda@mayo.edu.

Molly M Jeffery (MM)

Department of Emergency Medicine, Mayo Clinic, Rochester, MN, USA; Division of Health Care Delivery Research, Mayo Clinic, Rochester, MN, USA.

Susan M Bower (SM)

Department of Emergency Medicine, Mayo Clinic, Rochester, MN, USA; Department of Nursing, Mayo Clinic, Rochester, MN, USA.

Allyson K Palmer (AK)

Department of Medicine, Division of Community Internal Medicine, Geriatric Medicine and Palliative Care, Section of Senior Services and Geriatric Medicine, Mayo Clinic, Rochester, MN, USA; Department of Medicine, Division of Hospital Internal Medicine, Mayo Clinic, Rochester, MN, USA.

Ericka E Tung (EE)

Department of Medicine, Division of Community Internal Medicine, Geriatric Medicine and Palliative Care, Section of Senior Services and Geriatric Medicine, Mayo Clinic, Rochester, MN, USA.

Aidan F Mullan (AF)

Department of Quantitative Health Sciences, Division of Biostatistics and Informatics, Mayo Clinic, Rochester, MN, USA.

Christopher R Carpenter (CR)

Department of Emergency Medicine, Mayo Clinic, Rochester, MN, USA; Department of Medicine, Division of Community Internal Medicine, Geriatric Medicine and Palliative Care, Section of Senior Services and Geriatric Medicine, Mayo Clinic, Rochester, MN, USA.

Lucas Oliveira J E Silva (L)

Department of Emergency Medicine, Mayo Clinic, Rochester, MN, USA; Department of Emergency Medicine, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil.

Classifications MeSH