Trends and Characteristics of Emergency Department Visits for Fall-Related Injuries in Older Adults, 2003-2010

Abstract

IntroductionOne third of older adults fall each year, and falls are costly to both the patient in terms of morbidity and mortality and to the health system. Given that falls are a preventable cause of injury, our objective was to understand the characteristics and trends of emergency department (ED) fall-related visits among older adults. We hypothesize that falls among older adults are increasing and examine potential factors associated with this rise, such as race, ethnicity, gender, insurance and geography.MethodsWe conducted a secondary analysis of data from the National Hospital Ambulatory Medical Care Survey (NHAMCS) to determine fall trends over time by examining changes in ED visit rates for falls in the United States between 2003 and 2010, detailing differences by gender, sociodemographic characteristics and geographic region.ResultsBetween 2003 and 2010, the visit rate for falls and fall-related injuries among people age ≥ 65 increased from 60.4 (95% confidence interval [CI][51.9–68.8]) to 68.8 (95% CI [57.8–79.8]) per 1,000 population (p=0.03 for annual trend). Among subgroups, visits by patients aged 75–84 years increased from 56.2 to 82.1 per 1,000 (P <.01), visits by women increased from 67.4 to 81.3 (p = 0.04), visits by non-Hispanic Whites increased from 63.1 to 73.4 (p < 0.01), and visits in the South increased from 54.4 to 71.1 (p=0.03).ConclusionED visit rates for falls are increasing over time. There is a national movement to increase falls awareness and prevention. EDs are in a unique position to engage patients on future fall prevention and should consider ways they can also partake in such initiatives in a manner that is feasible and appropriate for the ED setting.

GAPcare: The Geriatric Acute and Post‐Acute Fall Prevention Intervention in the Emergency Department: Preliminary Data

“…Fortunately, our intervention is brief (20 min per consultation), and our pharmacy and PT professionals could provide both an assessment and actionable advice to participants in this short period of time. There is no universally acceptable screening method for falls in EDs, and fall frequency and mortality are increasing . This situation argues for a prompt response to this epidemic.…”

“…The mortality of falls and fall‐related ED visits by older adults are increasing . Falls are a leading reason for SNF placement, which are more costly than community‐based care .…”

“…There is no universally acceptable screening method for falls in EDs, and fall frequency and mortality are increasing. 39 This situation argues for a prompt response to this epidemic. However, evidence indicates that not all older adults with falls presenting to the ED may need an intervention.…”

“…The mortality of falls 54 and fall-related ED visits by older adults are increasing. 1,39,55 Falls are a leading reason for SNF placement, which are more costly than community-based care. 56 Geriatric assessments are associated with a higher likelihood of discharge to the community.…”

Polypharmacy and Incident Frailty in a Longitudinal Community‐Based Cohort Study

“…Poor health outcomes (eg, hypertension, diabetes, and stroke) are common among middle and older adults in the US South . Therefore, increased research on health outcomes and prevention strategies in this population is warranted . To help inform future deprescribing interventions, this longitudinal study examines the association between polypharmacy and incident frailty using the commonly used Fried frailty phenotype in a community‐based prospective cohort of middle‐aged to older adults residing in a predominantly rural county of North Carolina…”