Risk Factors of Fall-Related Emergency Department Visits by Fall Location of Older Adults in the US
| Autor: | Uma Kelekar, Debasree Das Gupta, Jewel Goodman Shepherd, Anupam A. Sule |
|---|---|
| Přispěvatelé: | University of California eScholarship |
| Rok vydání: | 2020 |
| Předmět: |
Male
Population health outdoor 03 medical and health sciences 0302 clinical medicine Risk Factors medicine Humans 030212 general & internal medicine indoor older adults Original Research Aged RC86-88.9 business.industry Vantage point falling Medical emergencies. Critical care. Intensive care. First aid 030208 emergency & critical care medicine General Medicine Emergency department Confidence interval United States Falling (accident) Geriatrics Relative risk Emergency Medicine Medicine Residence Accidental Falls Female Rural area medicine.symptom business Emergency Service Hospital Demography |
| Zdroj: | Kinesiology and Health Science Faculty Publications Western Journal of Emergency Medicine, Vol 22, Iss 4 (2021) Western Journal of Emergency Medicine |
| ISSN: | 1936-9018 |
| Popis: | Author(s): Kelekar, Uma; Das Gupta, Debasree; Shepherd, Jewel Goodman; Sule, Anupam S. | Abstract: Introduction: Prior evidence indicates that predictors of older adult falls vary by indoor-outdoor location of the falls. While a subset of United States’ studies reports this finding using primary data from a single geographic area, other secondary analyses of falls across the country do not distinguish between the two fall locations. Consequently, evidence at the national level on risk factors specific to indoor vs outdoor falls is lacking. Methods: Using the 2017 Nationwide Emergency Department Sample (NEDS) data, we conducted a multivariable analysis of fall-related emergency department (ED) visits disaggregated by indoor vs outdoor fall locations of adults 65 years and older (N = 6,720,937) in the US.n Results: Results are compatible with findings from previous primary studies. While women (relative risk [RR] = 1.43, 95% confidence interval [CI], 1.42-1.44) were more likely to report indoor falls, men were more likely to present with an outdoor fall. Visits for indoor falls were highest among those 85 years and older (RR = 2.35, 95% CI, 2.33-2.37) with outdoor fall visits highest among those 84 years and younger. Additionally, the probabilities associated with an indoor fall in the presence of chronic conditions were consistently much higher when compared to an outdoor fall. We also found that residence in metropolitan areas increased the likelihood of an indoor elderly fall compared to higher outdoor fall visits from seniors in non-core rural areas, but both indoor and outdoor fall visits were higher among older adults in higher income ZIP codes. Conclusion: Our findings highlight the contrasting risk profile for elderly ED patients who report indoor vs outdoor falls when compared to the elderly reporting no falls. In conjunction, we highlight implications from three perspectives: a population health standpoint for EDs working with their primary care and community care colleagues; an ED administrative vantage point; and from an individual emergency clinician’s point of view. |
| Databáze: | OpenAIRE |
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