Geriatrics
Abstracts
Jesse Brennan, MA
University of California San Diego School of Medicine
Edward Castillo, PhD, MPH
University of California San Diego School of Medicine
Disclosure Relationship(s): Nothing to disclose
Lauren Southerland, MD
The Ohio State University
Background: Geriatric patients are at risk of falls, which can lead to many adverse outcomes, including increased risk of death. As the geriatric population increases, more ED visits related to falls are anticipated. We describe the characteristics of geriatric patients who presented to the ED for a fall-related complaint.
Methods: This was a multi-center retrospective review of non-military, acute care hospitals in California from Jan 1, 2016 through Dec 31, 2016 using non-public statewide databases. Included were geriatric patients (ages 65 and older) who had a fall-related ED visit. Fall-related ED visits were identified by ICD-10-CM codes W00x to W19x (excluding ED visits resulting in admission in which the injury was not present upon admission). Patient demographics, injuries and disposition are described. Additionally, 7-day ED utilization following a fall-related ED discharge are also reported.
Results: A total of 2,609,255 ED visits were identified among 1,391,749 unique geriatric patients in the study period. Of these, there were 323,751 fall-related ED visits (12.4%) among 264,932 unique patients (19%). The majority of patients were female (65.3%), and patient age was similar across age groups: 65-74 years (32.9%), 75-84 years (33.6%), and 85 years and older (33.5%). The most frequent type of fall was “fall on same level from slipping, tripping, and stumbling”(33.8% of visits), while the most frequent primary diagnosis was head injury (27.3% of visits). The majority of ED visits resulted in discharge (218,644 or 67.5%), and 92,224 (28.5%) of ED visits resulted in hospital admission. Among qualifying ED discharges (224,591 visits), 25,073 (11.2%) resulted in a return ED visit within 7 days, with an admission rate of 29.4%. 17.4% of return visits resulted in the same primary diagnosis as the preceding visit. The most common primary diagnosis among return ED visits was an open wound to the head (4.2%) while the most common primary diagnosis among return ED visits resulting in admission was septicemia (9.7%).
Conclusion: During the course of one year, 12% of statewide ED visits among a geriatric population were related to falls. Approximately one quarter of ED visits related to a fall resulted in hospitalization and 11% of fall-related ED discharges resulted in a 7-day return ED visit. Interventions targeting geriatric fall prevention may be of use in the ED.