Florida Atlantic University, Charles E. Schmidt College of Medicine, United States of America; Depatment of Emergency Medicine, Delray Medical Center, United States of America.
Florida Atlantic University, Charles E. Schmidt College of Medicine, United States of America; Depatment of Emergency Medicine, Delray Medical Center, United States of America; Depatment of Emergency Medicine, Bethesda Hospital East, United States of America.
Am J Emerg Med. 2024 Jan;75:29-32. doi: 10.1016/j.ajem.2023.10.021. Epub 2023 Oct 20.
Falls are the leading cause of injuries in the US for older adults. Follow-up after an ED-related fall visit is essential to initiate preventive strategies in these patients who are at very high risk for recurrent falls. It is currently unclear how frequently follow-up occurs and whether preventive strategies are implemented. Our objective is to determine the rate of follow-up by older adults who sustain a fall related head injury resulting in an ED visit, the rate and type of risk assessment and adoption of preventive strategies.
This 1-year prospective observational study was conducted at two South Florida hospitals. All older ED patients with an acute head injury due to a fall were identified. Telephone surveys were conducted 14 days after ED presentation asking about PCP follow-up and adoption of fall prevention strategies. Clinical and demographic characteristics were compared between patients with and without follow up.
Of 4951 patients with a head injury from a fall, 1527 met inclusion criteria. 905 reported follow-up with their PCP. Of these, 72% reported receiving a fall assessment and 56% adopted a fall prevention strategy. Participants with PCP follow-up were significantly more likely to have a history of cancer or hypertension.
Only 60% of ED patients with fall-related head injury follow-up with their PCP. Further, 72% received a fall assessment and only 56% adopted a fall prevention strategy. These data indicate an urgent need to promote PCP fall assessment and adoption of prevention strategies in these patients.
在美国，老年人因跌倒而受伤是导致受伤的主要原因。对 ED 相关跌倒就诊后的患者进行随访，对于这些极有可能再次跌倒的患者来说，启动预防策略至关重要。目前尚不清楚随访的频率，以及是否实施了预防策略。我们的目的是确定因跌倒导致头部受伤并导致 ED 就诊的老年人的随访率、风险评估的频率和类型，以及预防策略的实施率。
这是一项为期 1 年的前瞻性观察性研究，在佛罗里达州的两家医院进行。所有因急性头部外伤而在 ED 就诊的老年患者均被识别。在 ED 就诊后 14 天进行电话调查，询问他们是否就诊于 PCP 以及是否采取了预防跌倒的策略。比较了有随访和无随访的患者的临床和人口统计学特征。
在因跌倒导致头部受伤的 4951 名患者中，有 1527 名符合纳入标准。905 名患者报告与 PCP 进行了随访。其中，72%的患者报告接受了跌倒评估，56%的患者采取了预防跌倒的策略。有 PCP 随访的患者更有可能患有癌症或高血压病史。
只有 60%的跌倒相关头部受伤的 ED 患者会去看他们的 PCP。进一步的，72%的患者接受了跌倒评估，只有 56%的患者采取了预防跌倒的策略。这些数据表明，迫切需要促进 PCP 对这些患者进行跌倒评估，并采取预防策略。
