Pacientes ancianos atendidos en urgencias por caídas (Registro FALL-ER): probabilidad de nuevas caídas y factores asociados.

OBJECTIVES: To identify characteristics associated with a new fall in a patient who received emergency department care after an accidental fall and to develop a risk model to predict repeated falls. MATERIAL AND METHODS: The FALL-ER registry included accidental falls in patients over the age of 65 y...

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Detalles Bibliográficos
Autores: García-Martínez A, Gil-Rodrigo A, Placer A, Alemany X, Aguiló S, Torres-Machado V, Jacob J, Herrero P, Llorens P, Martín-Sánchez FJ, Miró Ò
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2022
País:España
Institución:Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)
Repositorio:r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
OAI Identifier:oai:isabial.fundanetsuite.com:p9444
Acceso en línea:https://isabial.portalinvestigacion.com/publicaciones9444
Access Level:acceso abierto
Palabra clave:Accidental falls.
Aged.
Ancianos.
Caída.
Emergency department.
Urgencias.
Descripción
Sumario:OBJECTIVES: To identify characteristics associated with a new fall in a patient who received emergency department care after an accidental fall and to develop a risk model to predict repeated falls. MATERIAL AND METHODS: The FALL-ER registry included accidental falls in patients over the age of 65 years treated in 5 Spanish emergency departments. Independent variables analyzed were patient characteristics at baseline, fall characteristics, immediate consequences, and functional status on discharge. Patients were followed with telephone interviews for 6 months to record the occurrence of new falls. Multivariate regression analysis was used to identify variables associated with falling again and to develop a risk model. We identified 3 levels of risk for new falls (low, intermediate, and high). RESULTS: A total of 1313 patients were studied; 147 patients (11.2%) reported having another fall. Variables associated with risk of falling again were having had a fall in the 12 months before the index fall, neurological disease, anemia, use of non-opioid analgesics, falling at home, falling at night, head injury on falling, and need for help when rising from a chair. The probability of falling again was 3.5%, 10.5%, and 23.3%, respectively, in patients at low, intermediate, and high risk. The model's ability to discriminate was moderate: the area under the receiver operating characteristic curve was 0.688 (95% CI, 0.640-0.736). CONCLUSION: One in 9 older adults treated in an emergency department for an accidental fall will fall again within 6 months. It is possible to identify patients at higher risk for whom preventive measures should be implemented.