Geriatric screening, fall characteristics and 3-and 12 months adverse outcomes in older patients visiting the emergency department with a fall
| Autor: | Bas de Groot, Leonie J. van Meer, Simon P. Mooijaart, Jacobijn Gussekloo, Jelle de Gelder, Sander Anten, Jacinta A. Lucke, Julia Leander, Laura C. Blomaard |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Male
Geriatric screening medicine.medical_specialty Adverse outcomes Psychological intervention Critical Care and Intensive Care Medicine Logistic regression Geriatric emergency medicine Risk Assessment Older patients Outcome Assessment Health Care Medicine Humans Geriatric Assessment Original Research Retrospective Studies Aged Aged 80 and over Frailty business.industry lcsh:Medical emergencies. Critical care. Intensive care. First aid lcsh:RC86-88.9 Odds ratio Emergency department Older adults Emergency medicine Emergency Medicine Observational study Accidental Falls Female Falls business Emergency Service Hospital |
| Zdroj: | Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 29(1). BMC Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, Vol 29, Iss 1, Pp 1-9 (2021) |
| Popis: | Background Falls in older Emergency Department (ED) patients may indicate underlying frailty. Geriatric follow-up might help improve outcomes in addition to managing the direct cause and consequence of the fall. We aimed to study whether fall characteristics and the result of geriatric screening in the ED are independently related to adverse outcomes in older patients with fall-related ED visits. Methods This was a secondary analysis of the observational multicenter Acutely Presenting Older Patient (APOP) study, of which a subset of patients aged ≥70 years with fall-related ED visits were prospectively included in EDs of two Dutch hospitals. Fall characteristics (cause and location) were retrospectively collected. The APOP-screener was used as a geriatric screening tool. The outcome was 3- and 12-months functional decline and mortality. We assessed to what extent fall characteristics and the geriatric screening result were independent predictors of the outcome, using multivariable logistic regression analysis. Results We included 393 patients (median age 80 (IQR 76–86) years) of whom 23.0% were high risk according to screening. The cause of the fall was extrinsic (49.6%), intrinsic (29.3%), unexplained (6.4%) or missing (14.8%). A high risk geriatric screening result was related to increased risk of adverse outcomes (3-months adjusted odds ratio (AOR) 2.27 (1.29–3.98), 12-months AOR 2.20 (1.25–3.89)). Independent of geriatric screening result, an intrinsic cause of the fall increased the risk of 3-months adverse outcomes (AOR 1.92 (1.13–3.26)) and a fall indoors increased the risk of 3-months (AOR 2.14 (1.22–3.74)) and 12-months adverse outcomes (AOR 1.78 (1.03–3.10)). Conclusions A high risk geriatric screening result and fall characteristics were both independently associated with adverse outcomes in older ED patients, suggesting that information on both should be evaluated to guide follow-up geriatric assessment and interventions in clinical care. |
| Databáze: | OpenAIRE |
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