Seniors' Falls Linked to Adverse Events

Risk factors associated with adverse events within six months of an emergency department visit for a fall included diabetes, polypharmacy (five or more medications), and psychiatric and/or sedative medications.

More than half patients age 65 and older who visited an emergency department for injuries sustained in a fall suffered adverse events – including additional falls, hospitalization and death – within six months, according to a small sample study this week in the Annals of Emergency Medicine.

“Our study shows an even higher rate of adverse events than previous studies have,” said lead author Jiraporn Sri-on, MD, of Navamindradhiraj University in Bangkok, Thailand. “Patients taking psychiatric and/or sedative medications had even more adverse events. This is concerning because these types of drugs are commonly prescribed for elderly patients in community and residential care settings.”

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The findings rely upon an analysis of 350 elderly fall patients who presented to the ED at one urban teaching hospital in 2012. Of patients who visited the ED for injuries sustained in a fall, 7.7% developed adverse events within 7 days, 21.4% developed adverse events within 30 days and 50.3% developed adverse events within six months. Within six months, 22.6% had at least one additional fall, 42.6% revisited the emergency department, 31% had subsequent hospitalization and 2.6% had died.

Risk factors associated with adverse events within six months of an emergency department visit for a fall included diabetes, polypharmacy (five or more medications), and psychiatric and/or sedative 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."

The American College of Emergency Physicians recently produced a public education video to help prevent falls.