Recurrent Fallers
What about recurrent fallers?
- After a fall, patients are 2× as likely to fall again
- Increased ED visit rate after falls
- Increased mortality after an ED visit for a fall for older adults
NOTE
A study published in 2015 was a retrospective analysis that looked at the number of elderly ED visits for falls from 2005–2011. It looked at revisit rates at 3 days, 7 days, and 1 year, and found that ED revisit rates increased from 2% at 3 days to 25% at 1 year after an initial visit for a fall.
Importantly, death rates after the initial ED visit for a fall increased from 1.2% at 3 days to 15% at 1 year.
Key Concept
Falls are a BIG deal
This important point further illustrates that falls are not only common but a BIG deal. We often say that a fall was “mechanical”—to differentiate a fall from syncope or seizure. However, this term is not well-defined and tends to downplay the seriousness of all falls.
The fact that >1/3 of older adult ED fall patients had an ED revisit or died within 1 year is HUGE. By comparison the 1-year mortality after MI is about 3%. This is especially important information for ED providers to consider since we have the most encounters with these patients and therefore have the most potential to intervene and prevent future falls.
References
Liu SW et al. Am J Emerg Med. 2015;33(8):1012–1018.
Abbreviations
ED, emergency department; MI, myocardial infarction.