TY - JOUR
T1 - Assessing the prevalence of modifiable risk factors in older patients visiting an ED due to a fall using the CAREFALL Triage Instrument
AU - van Nieuwenhuizen, Roos C.
AU - van Dijk, Nynke
AU - van Breda, Fenna G.
AU - Scheffer, Alice C.
AU - Korevaar, Johanna C.
AU - van der Cammen, Tischa J.
AU - Lips, Paul
AU - Goslings, Johannes C.
AU - de Rooij, Sophia E.
AU - CAREFALL Study Grp
PY - 2010/11
Y1 - 2010/11
N2 - Objective: Falls in older people are a common presenting complaint. Knowledge of modifiable risk factors may lead to a more tailored approach to prevent recurrent falls and/or fractures. We investigated prevalence of 8 modifiable risk factors for recurrent falling and/or a serious consequence of the fall among older patients visiting the emergency department after a fall with the Combined Amsterdam and Rotterdam Evaluation of Falls Triage Instrument (CTI), a self-administrated questionnaire that consists of questions concerning demographics, possible cause(s) of the fall, and questions relating to (modifiable) risk factors for falling.Methods: After treatment for their injuries, 1077 consecutive patients 65 years or older visiting the accident and emergency department due to a fall were evaluated by the CTI. The following were assessed: impaired vision, mobility disorder, fear of falling, mood disorder, high risk of osteoporosis, orthostatic hypotension, incontinence, and polypharmacy.Results: The percentage of respondents who returned the questionnaire was 59.3%. The mean (SD) age was 78.5 (7.5) years, and 57.8% experienced a fall with serious consequences. There were 60.9% of patients with a recurrent fall versus 51% with a first fall who experienced with a serious consequence (P = .025). Age and risk factors mobility disorder (odds ratio [OR], 1.9; 95% confidence interval [Cl], 1.1-3.3), high risk of osteoporosis (OR, 2.0; 95% Cl, 1.2-3.2), incontinence (OR, 1.7; 95% Cl, 1.0-2.7), fear of falling (OR, 2.2; 95% Cl, 1.3-3.7), and orthostatic hypotension (OR, 2.4; 95% Cl, 1.4-4.2) were independently associated with a recurrent fall. Age and high risk of osteoporosis were the only risk factors predicting a serious consequence of a fall (OR, 4.6; 95% Cl, 2.9-7.2).Conclusions: Age and 5 modifiable risk factors assessed with the CTI were independently associated with a recurrent fall. Only high risk of osteoporosis was associated with a serious consequence. (C) 2010 Elsevier Inc. All rights reserved.
AB - Objective: Falls in older people are a common presenting complaint. Knowledge of modifiable risk factors may lead to a more tailored approach to prevent recurrent falls and/or fractures. We investigated prevalence of 8 modifiable risk factors for recurrent falling and/or a serious consequence of the fall among older patients visiting the emergency department after a fall with the Combined Amsterdam and Rotterdam Evaluation of Falls Triage Instrument (CTI), a self-administrated questionnaire that consists of questions concerning demographics, possible cause(s) of the fall, and questions relating to (modifiable) risk factors for falling.Methods: After treatment for their injuries, 1077 consecutive patients 65 years or older visiting the accident and emergency department due to a fall were evaluated by the CTI. The following were assessed: impaired vision, mobility disorder, fear of falling, mood disorder, high risk of osteoporosis, orthostatic hypotension, incontinence, and polypharmacy.Results: The percentage of respondents who returned the questionnaire was 59.3%. The mean (SD) age was 78.5 (7.5) years, and 57.8% experienced a fall with serious consequences. There were 60.9% of patients with a recurrent fall versus 51% with a first fall who experienced with a serious consequence (P = .025). Age and risk factors mobility disorder (odds ratio [OR], 1.9; 95% confidence interval [Cl], 1.1-3.3), high risk of osteoporosis (OR, 2.0; 95% Cl, 1.2-3.2), incontinence (OR, 1.7; 95% Cl, 1.0-2.7), fear of falling (OR, 2.2; 95% Cl, 1.3-3.7), and orthostatic hypotension (OR, 2.4; 95% Cl, 1.4-4.2) were independently associated with a recurrent fall. Age and high risk of osteoporosis were the only risk factors predicting a serious consequence of a fall (OR, 4.6; 95% Cl, 2.9-7.2).Conclusions: Age and 5 modifiable risk factors assessed with the CTI were independently associated with a recurrent fall. Only high risk of osteoporosis was associated with a serious consequence. (C) 2010 Elsevier Inc. All rights reserved.
KW - RANDOMIZED CONTROLLED-TRIAL
KW - MULTIFACTORIAL INTERVENTION
KW - EMERGENCY-DEPARTMENT
KW - ELDERLY PERSONS
KW - INJURIOUS FALLS
KW - RECURRENT FALLS
KW - COMMUNITY
KW - PREVENTION
KW - PEOPLE
KW - ACCIDENT
U2 - 10.1016/j.ajem.2009.06.003
DO - 10.1016/j.ajem.2009.06.003
M3 - Article
SN - 0735-6757
VL - 28
SP - 994
EP - 1001
JO - American journal of emergency medicine
JF - American journal of emergency medicine
IS - 9
ER -