Assessing the prevalence of modifiable risk factors in older patients visiting an ED due to a fall using the CAREFALL Triage Instrument

Nieuwenhuizen, R.C. van; Dijk, Nynke van; Breda, Fenna G. van; Scheffer, Alice C.; Korevaar, Johanna C.; Cammen, Tischa Jm van der; Lips, Paul; Goslings, J. Carel; Rooij, Sophia E. de

doi:10.1016/j.ajem.2009.06.003

Cited by 29 publications

(33 citation statements)

References 27 publications

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“…A literatura não é conclusiva sobre incontinência urinária e queda, mas alguns achados brasileiros e internacionais indicaram-na como fator de risco para quedas entre idosos 18,26,27,28,29 .…”

Section: Discussionunclassified

“…No projeto, a dor não aparece como provável fator de risco, pois os dados analisados referem-se à coleta do ano 2000, quando as questões sobre dor ainda não haviam sido incluídas. Do descrito, nota-se que as três variáveis que se mantiveram no modelo final são também reconhecidas em outras pesquisas como fatores de risco para quedas em idosos: osteoporose 24,28,30 , incontinência urinária 7,15,18,22,25,26,27 e artrite 7,9,25,26 . Todavia, há estudos nos quais incontinência urinária 1,15,29 , artrite 31 e osteoporose 26,29,32 não apresentaram relação com queda.…”

Section: Discussionunclassified

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Associação entre dor crônica e autorrelato de quedas: estudo populacional ? SABE

et al. 2014

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Section: Discussionunclassified

Associação entre dor crônica e autorrelato de quedas: estudo populacional ? SABE

et al. 2014

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“…These included lightheadedness or dizziness, syncope, headache, visual disturbances, neck or chest discomfort, palpitations, nausea, and generalised weakness experienced both during the measurement of postural blood pressure as well as over the previous year prior to the study. (19) Selected aspects of the patients' social history were also assessed, including their physical activity at work or during recreation, ambulatory status, (3) history of falls, (8,9) alcohol intake, (18) caffeine intake, and smoking history.…”

Section: Methodsmentioning

confidence: 99%

“…(3)(4)(5) OH is a well-established clinical entity (6)(7)(8) that is associated with a wide range of morbidities in the literature, such as cardiovascular disease, cognitive decline and an increased risk of falls. (4,5,(9)(10)(11) Despite this, its current prevalence among the local elderly population attending primary healthcare settings is not well-established. The first set of data collected locally in 1987 suggested a prevalence of 22% in a hospitalised population.…”

Section: Introductionmentioning

confidence: 99%

Orthostatic hypotension: prevalence and associated risk factors among the ambulatory elderly in an Asian population

Zhu¹,

Tan²,

Tan³

et al. 2016

smedj

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INTRODUCTIONThe 1996 consensus statement by the Consensus Committee of the American Autonomic Society and the American Academy of Neurology (1,2) defines orthostatic hypotension (OH) as a drop in systolic blood pressure ≥ 20 mmHg or diastolic blood pressure ≥ 10 mmHg within three minutes of standing from a supine or seated position. (3)(4)(5) OH is a well-established clinical entity (6)(7)(8) that is associated with a wide range of morbidities in the literature, such as cardiovascular disease, cognitive decline and an increased risk of falls. (4,5,(9)(10)(11) Despite this, its current prevalence among the local elderly population attending primary healthcare settings is not well-established. The first set of data collected locally in 1987 suggested a prevalence of 22% in a hospitalised population.(12) Another sub-analysis in a longitudinal study in 1999 showed a prevalence of 16.6% in a communitydwelling Chinese population aged 55 years and above, but did not include patients with comorbidities such as previous stroke and cardiovascular diseases.(5) Overseas population studies provided wide variations in estimates of OH prevalence ranging from 5% to 34%. The variation is attributable to the different demographic characteristics and settings of study populations. (13) The magnitude of OH and understanding of its associated risk factors has an impact on the design of screening programmes, clinical practice and health service delivery to the geriatric population in the local community. Thus, the primary objective of this study was to determine the prevalence of OH among elderly patients aged ≥ 65 years (an accepted definition of old age in most developed countries) (14) who attended a typical public primary care clinic (i.e. polyclinic) in Singapore. The secondary objective of this study was to assess the associations between OH and various clinical and non-clinical factors. Such information would allow us to identify factors that can increase the risk of OH, so that appropriate measures can be introduced to mitigate associated adverse outcomes in at-risk patients. METHODSThe study was conducted over two weeks in February 2013. Participants attended SingHealth Polyclinics-Geylang, a typical public primary care clinic located in the mideastern part of Singapore. Elderly patients aged ≥ 65 years constituted about 27% of the clinic's 700-900 daily patient attendance in 2014 (according to unpublished data). Our target group consisted of community-dwelling, multiethnic Asian elderly adults who were ambulatory; aged ≥ 65 years and above; and managed at the study site for their existing chronic medical conditions, such as diabetes mellitus, hypertension and hyperlipidaemia. The exclusion

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“…Programs for the identification of modifiable risk factors and secondary prevention of falls are most often aimed at those patients presenting to the Accident & Emergency (A&E) Department after a fall [16-18]. However, little is known about the prevalence of modifiable risk factors and their association with falling in older persons with a fall history who do not visit the A&E Department after one or more falls.…”

Section: Introductionmentioning

confidence: 99%

Risk factors associated with visiting or not visiting the accident & emergency department after a fall

Scheffer

Hensbroek

Dijk

et al. 2013

BMC Health Serv Res

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BackgroundLittle is known about the prevalence of modifiable risk factors of falling in elderly persons with a fall-history who do not visit the Accident and Emergency (A&E) Department after one or more falls. The objective of this study was to determine the prevalence of modifiable risk factors in a population that visited the A&E Department after a fall (A&E group) and in a community-dwelling population of elderly individuals with a fall history who did not visit the A&E Department after a fall (non-A&E group).MethodsTwo cohorts were included in this study. The first cohort included 547 individuals 65 years and older who were visited at home by a mobile fall prevention team. The participants in this cohort had fall histories but did not visit the A&E Department after a previous fall. These participants were age- and gender-matched to persons who visited the A&E Department for care after a fall. All participants were asked to complete the CAREFALL Triage Instrument.ResultsThe mean number of modifiable risk factors in patients who did not visit the A&E Department was 2.9, compared to 3.8 in the group that visited the A&E Department (p<0.01). All risk factors were present in both groups but were more prevalent in the A&E group, except for the risk factors of balance and mobility (equally prevalent in both groups) and orthostatic hypotension (less prevalent in the A&E group). The risk factors of polypharmacy, absence of orthostatic hypotension, fear of falling, impaired vision, mood and high risk of osteoporosis were all independently associated with visiting the A&E Department.ConclusionAll modifiable risk factors for falling were found to be shared between community-dwelling elderly individuals with a fall history who visited the A&E Department and those who did not visit the Department, although the prevalence of these factors was somewhat lower in the A&E group. Preventive strategies aimed both at patients presenting to the A&E Department after a fall and those not presenting after a fall could perhaps reduce the number of recurrent falls, the occurrence of injury and the frequency of visits to the A&E Department.

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Assessing the prevalence of modifiable risk factors in older patients visiting an ED due to a fall using the CAREFALL Triage Instrument

Cited by 29 publications

References 27 publications

Associação entre dor crônica e autorrelato de quedas: estudo populacional ? SABE

Associação entre dor crônica e autorrelato de quedas: estudo populacional ? SABE

Orthostatic hypotension: prevalence and associated risk factors among the ambulatory elderly in an Asian population

Risk factors associated with visiting or not visiting the accident & emergency department after a fall

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