Departments of Medicine and Geriatrics, University of Montreal, Montreal, Quebec, Canada; Research Centre of the Geriatric University Institute of Montreal, Montreal, Quebec, Canada; Department of Medicine, Division of Geriatric Medicine, Sir Mortimer B. Davis Jewish General Hospital, Lady Davis Institute for Medical Research, McGill University, Montreal, Quebec, Canada.
Research Centre of the Geriatric University Institute of Montreal, Montreal, Quebec, Canada.
Maturitas. 2023 Dec;178:107838. doi: 10.1016/j.maturitas.2023.107838. Epub 2023 Aug 23.
"Emergency Room Evaluation and Recommendations" (ER) is a validated clinical tool which stratifies the risk of the occurrence of adverse outcomes in three levels (i.e., low, moderate and high) in older people attending emergency departments. This study examines the association of ER risk levels with incident falls, their recurrence and post-fall fractures in older community women.
7147 participants of the EPIDémiologie de l'OStéoporose (EPIDOS) study - an observational population-based cohort study - were selected. ER low, moderate and high risk levels were determined at baseline. Incident fall outcomes (i.e., one incident fall without fracture, one incident fall with fracture, ≥2 falls without fracture and ≥ 2 falls with fracture) were collected prospectively every 4 months over a 4-year follow-up period.
The overall incidence of falls was 26.4.%, regardless of their characteristics. ER low risk level (hazard ratio (HR) ≤0.80 with P ≤ 0.001) and high risk (HR ≥ 1.26 with P ≤ 0.001) were associated respectively with low and high incident fall outcomes, except for recurrent falls without fracture.
ER low and high risk levels were associated with incident falls outcomes in EPIDOS participants, suggesting that the ER tool may be useful for stratifying the risk of falls in the older population.
“急诊室评估和建议”（ER）是一种经过验证的临床工具，可将急诊科就诊的老年人发生不良结局的风险分为低、中、高三个级别（即低、中、高）。本研究探讨了 ER 风险水平与老年社区女性跌倒事件、复发和跌倒后骨折的关系。
从 EPIDémiologie de l'OStéoporose（EPIDOS）研究中选择了 7147 名参与者，该研究是一项观察性的基于人群的队列研究。在基线时确定 ER 低、中、高风险水平。前瞻性地收集 4 年随访期间每 4 个月发生的跌倒事件（即无骨折的一次跌倒事件、有骨折的一次跌倒事件、无骨折的≥2 次跌倒事件和有骨折的≥2 次跌倒事件）。
无论其特征如何，跌倒的总发生率为 26.4%。ER 低风险水平（风险比（HR）≤0.80，P≤0.001）和高风险水平（HR≥1.26，P≤0.001）分别与低和高的跌倒事件发生率相关，除了无骨折的复发性跌倒。
ER 的低风险和高风险水平与 EPIDOS 参与者的跌倒事件结局相关，这表明 ER 工具可能有助于对老年人的跌倒风险进行分层。
