Elderly patients who receive emergency care after a fall may be more likely to suffer adverse events in the months following that care, according to a new study.
Researchers studied a group of 350 patients aged 65 and over who were treated in the ER for injuries after a fall, and found that half suffered an adverse event within six months. For 27 patients, or 7.7% of the study group, this occurred within the first seven days after treatment.
Within six months, 22.6% of the study group had a second fall, 42.6% visited the emergency department, 31.1% were subsequently hospitalized and 2.6%, or nine patients, died, according to the study, which was published in the Annals of Emergency Medicine.
Emergency doctors can be on the lookout for risk factors that could prevent such falls, said lead study author Jiraporn Sri-on, M.D., an emergency physician at Navamindradhiraj University in Bangkok, Thailand, and a research fellow at Massachusetts General Hospital, in an announcement. He said patients in the study who were taking sedative or psychiatric medications were more likely to suffer an adverse event, as were patients with diabetes or who take five or more medications.
"Emergency physicians have a tremendous opportunity to reduce the very high adverse event rate among older emergency patients who have fallen," Sri-on said. "Fall guidelines exist and work needs to be done to increase their implementation in emergency departments so patients can be educated on how not to fall again once they have been discharged from the emergency department."
Accidental falls are one of the leading causes of injury and death among elderly patients, and the American College of Emergency Physicians compiled a “7 Step Fall Challenge” to help older patients prevent falls. The recommendations include using activities like yoga to improve balance, getting annual eye exams and working with doctors to change medication regimens that lead to dizziness or disorientation. (A video on the program is embedded below.)
Providers can also deploy in-house programs aimed at reducing falls. Successful interventions include improved communication and use of call lights to alert nurses faster, emphasizing a “no one walks alone” internal culture and video monitoring of patients with high fall risk. Integrating medical internet of things technology has also shown promise in treating fall patients.