Falls and Balance Research Group, Neuroscience Research Australia, University of New South Wales, Randwick, Sydney, Australia.
Emerg Med J. 2012 Sep;29(9):742-7. doi: 10.1136/emermed-2011-200380. Epub 2011 Oct 1.
To document patient characteristics, care pathways, healthcare use and costs of fall-related emergency department (ED) presentations by older adults.
All fallers aged ≥70 years, presenting to the ED of a 450-bed metropolitan university hospital in Sydney, Australia (1 April 2007 through 31 March 2009) were studied. Data were collected from the ED electronic information system, ED clinical records and the hospital electronic information system database. Population estimates for 2008 for the local areas served by the hospital were used to estimate ED presentation rates.
Of 18 902 all-cause ED presentations, 3220 (17.0%) were due to a fall. Among fallers, 35.4% had one or more ED presentations and 20.3% had had one or more hospital admissions in the preceding 12 months. Fall-related ED presentation led directly to hospital admission in 42.7% of the cases, the majority of which (78.0%) received acute care only (length of stay-14.4 days for men and 13.7 days for women) and the remaining cases underwent further inpatient rehabilitation (length of stay 35.6 days for men and 30.1 days for women). After hospitalisation, 9.5% of patients became first-time residents of long-term care facilities. All fall-related ED presentations and hospitalisations cost a total of A$11 241 387 over the study period.
Older fallers presenting to the ED consume significant healthcare resources and are an easily identifiable high-risk population. They may benefit from systematic fall-risk assessment and tailored fall-prevention interventions.
记录老年人因跌倒相关而到急诊科（ED）就诊的患者特征、护理路径、医疗保健使用情况和费用。
所有≥70 岁的跌倒患者，在澳大利亚悉尼一家 450 床大都市大学医院的 ED 就诊（2007 年 4 月 1 日至 2009 年 3 月 31 日），均进行了研究。数据来自 ED 电子信息系统、ED 临床记录和医院电子信息系统数据库。使用医院服务的当地地区 2008 年的人口估计值来估算 ED 就诊率。
在 18902 例所有病因的 ED 就诊中，3220 例（17.0%）是由于跌倒。在跌倒患者中，35.4%有一次或多次 ED 就诊，20.3%在过去 12 个月内有一次或多次住院。跌倒相关的 ED 就诊直接导致 42.7%的患者住院，其中大多数（78.0%）仅接受急性治疗（男性住院时间为 14.4 天，女性为 13.7 天），其余病例接受进一步的住院康复治疗（男性为 35.6 天，女性为 30.1 天）。住院后，9.5%的患者首次成为长期护理机构的居民。在整个研究期间，所有与跌倒相关的 ED 就诊和住院共花费 1124.1387 万澳元。
到 ED 就诊的老年跌倒患者消耗大量医疗保健资源，是一个容易识别的高风险人群。他们可能受益于系统的跌倒风险评估和量身定制的跌倒预防干预措施。
