Yıl: 2021 Cilt: 3 Sayı: 3 Sayfa Aralığı: 171 - 176 Metin Dili: İngilizce DOI: 10.4274/ejgg.galenos.2021.2021-4-1 İndeks Tarihi: 19-01-2022

Factors Associated with Mortality in Geriatric Patients Presenting to the Emergency Department After Falls

Öz:
Objective: Few studies have investigated the impact of falls on mortality in older patients presenting to the emergency departments in our country. Thus, this study aimed to investigate the prognostic factors in geriatric patients with falls and identify the variables associated with repeated falls and mortality in the first 2 months after the fall. Materials and Methods: The study included patients over 65 years of age who presented to the emergency department of our university due to falls between January and December 2019. Results: A total of 170 patients were included in this study, with a mean age of 77.98±8.23 years (median 78 years, range 65-99 years), and 87 (51.2%) were male. Albumin level of <3.53 mg/dL was associated with an 8.066-fold higher risk of post-fall mortality [95% confidence interval (CI) 1.585-41.062, p=0.012], whereas hemoglobin level of <11.55 g/dL was associated with a 5.488-fold higher risk (95% CI 1.078-27.931, p=0.040). Conclusion: Among older adults who presented to the emergency department after falls, those with anemia and hypoalbuminemia at the time of admission had higher mortality. These two conditions were found to be independent risk factors for mortality. Thus, priority triage is recommended for these patients.
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  • 1. Ang GC, Low SL, How CH. Approach to falls among the elderly in the community. Singapore Med J 2020;61:116-121.
  • 2. Alamgir H, Muazzam S, Nasrullah M. Unintentional falls mortality among elderly in the United States: time for action. Injury 2012;43:2065-2071.
  • 3. Ensrud KE, Ewing SK, Cawthon PM, Fink HA, Taylor BC, Cauley JA, Dam TT, Marshall LM, Orwoll ES, Cummings SR; Osteoporotic Fractures in Men Research Group. A comparison of frailty indexes for the prediction of falls, disability, fractures, and mortality in older men. J Am Geriatr Soc 2009;57:492-498.
  • 4. Panel on Prevention of Falls in Older Persons, American Geriatrics Society and British Geriatrics Society. Summary of the Updated American Geriatrics Society/British Geriatrics Society clinical practice guideline for prevention of falls in older persons. J Am Geriatr Soc 2011;59:148-157.
  • 5. Orces CH. Emergency department visits for fall-related fractures among older adults in the USA: a retrospective cross-sectional analysis of the National Electronic Injury Surveillance System All Injury Program, 2001- 2008. BMJ Open 2013;3:e001722.
  • 6. Albert M, McCaig LF, Ashman JJ. Emergency department visits by persons aged 65 and over: United States, 2009-2010. NCHS Data Brief 2013;1-8.
  • 7. Miró Ò, Nayla Brizzi B, Aguiló S, Alemany X, Jacob J, Llorens P, Herrero Puente P, González Ramón B, Castro Jiménez V, Torres Machado V, Cenjor R, Gil A, Rico V, Martínez Nadal G, Lázaro Del Nogal M, Martín-Sánchez FJ. Profile of older patients attended in the emergency department after falls: a FALL-ER registry study of the magnitude of the problem and opportunities for improving hospital emergency care. Emergencias 2018;30:231-240.
  • 8. Carpenter CR, Avidan MS, Wildes T, Stark S, Fowler SA, Lo AX. Predicting geriatric falls following an episode of emergency department care: a systematic review. Acad Emerg Med 2014;21:1069-1082.
  • 9. Lin CH, Liao KC, Pu SJ, Chen YC, Liu MS. Associated factors for falls among the community-dwelling older people assessed by annual geriatric health examinations. PLoS One 2011;6:e18976.
  • 10. Thaler-Kall K, Döring A, Peters A, Thorand B, Grill E, Koenig W, Horsch A, Meisinger C. Association between anemia and falls in community-dwelling older people: cross-sectional results from the KORA-Age study. BMC Geriatr 2014;14:29.
  • 11. Penninx BW, Pluijm SM, Lips P, Woodman R, Miedema K, Guralnik JM, Deeg DJ. Late-life anemia is associated with increased risk of recurrent falls. J Am Geriatr Soc 2005;53:2106-2111.
  • 12. Tachi T, Yokoi T, Goto C, Umeda M, Noguchi Y, Yasuda M, Minamitani M, Mizui T, Tsuchiya T, Teramachi H. Hyponatremia and hypokalemia as risk factors for falls. Eur J Clin Nutr 2015;69:205-210.
  • 13. Hagiya H, Koyama T, Zamami Y, Tatebe Y, Funahashi T, Shinomiya K, Kitamura Y, Hinotsu S, Sendo T, Rakugi H, Kano MR. Fall-related mortality trends in older Japanese adults aged ≥65 years: a nationwide observational study. BMJ Open 2019;9:e033462.
  • 14. Traven SA, Reeves RA, Althoff AD, Slone HS, Walton ZJ. New Five-Factor Modified Frailty Index Predicts Morbidity and Mortality in Geriatric Hip Fractures. J Orthop Trauma 2019;33:319-323.
  • 15. Karres J, Kieviet N, Eerenberg JP, Vrouenraets BC. Predicting Early Mortality After Hip Fracture Surgery: The Hip Fracture Estimator of Mortality Amsterdam. J Orthop Trauma 2018;32:27-33.
  • 16. Stauder R, Valent P, Theurl I. Anemia at older age: etiologies, clinical implications, and management. Blood 2018;131:505-514.
  • 17. Vivanti A, Isenring E, Baumann S, Powrie D, O’Neill M, Clark D, Courtice S, Campbell K, Ferguson M. Emergency department malnutrition screening and support model improves outcomes in a pilot randomised controlled trial. Emerg Med J 2015;32:180-183.
  • 18. Marshall S, Young A, Isenring E. The Malnutrition Screening Tool in Geriatric Rehabilitation: A Comparison of Validity When Completed by Health Professionals With and Without Malnutrition Screening Training Has Implications for Practice. J Acad Nutr Diet 2018;118:118-124.
  • 19. Corti MC, Guralnik JM, Salive ME, Sorkin JD. Serum albumin level and physical disability as predictors of mortality in older persons. JAMA 1994;272:1036-1042.
  • 20. Symeonidis PD, Clark D. Assessment of malnutrition in hip fracture patients: effects on surgical delay, hospital stay and mortality. Acta Orthop Belg 2006;72:420-427.
  • 21. Kudsk KA, Tolley EA, DeWitt RC, Janu PG, Blackwell AP, Yeary S, King BK. Preoperative albumin and surgical site identify surgical risk for major postoperative complications. JPEN J Parenter Enteral Nutr 2003;27:1-9.
  • 22. Gibbs J, Cull W, Henderson W, Daley J, Hur K, Khuri SF. Preoperative serum albumin level as a predictor of operative mortality and morbidity: results from the National VA Surgical Risk Study. Arch Surg 1999;134:36-42.
  • 23. Cabrerizo S, Cuadras D, Gomez-Busto F, Artaza-Artabe I, Marín-Ciancas F, Malafarina V. Serum albumin and health in older people: Review and meta analysis. Maturitas 2015;81:17-27.
  • 24. Khan MA, Hossain FS, Ahmed I, Muthukumar N, Mohsen A. Predictors of early mortality after hip fracture surgery. Int Orthop 2013;37:2119-2124.
  • 25. Lo LWT, Yanling X, Chou ACC, Howe TS, Allen JC, Koh JSB. End-Stage Renal Failure Is an Independent Risk Factor for 1-Year Mortality After Hip Fracture Surgery. Geriatr Orthop Surg Rehabil 2018;9:2151459318770561.
  • 26. Papakonstantinopoulou K, Sofianos I. Risk of falls in chronic kidney disease. J Frailty Sarcopenia Falls 2017;2:33-38.
  • 27. Beaudart C, Zaaria M, Pasleau F, Reginster JY, Bruyère O. Health Outcomes of Sarcopenia: A Systematic Review and Meta-Analysis. PLoS One 2017;12:e0169548.
  • 28. Moorthi RN, Avin KG. Clinical relevance of sarcopenia in chronic kidney disease. Curr Opin Nephrol Hypertens 2017;26:219-228.
  • 29. Hammond T, Wilson A. Polypharmacy and falls in the elderly: a literature review. Nurs Midwifery Stud 2013;2:171-175.
  • 30. Angalakuditi MV, Gomes J, Coley KC. Impact of drug use and comorbidities on in-hospital falls in patients with chronic kidney disease. Ann Pharmacother 2007;41:1638-1643.
  • 31. Nijmeijer WS, Folbert EC, Vermeer M, Slaets JP, Hegeman JH. Prediction of early mortality following hip fracture surgery in frail elderly: The Almelo Hip Fracture Score (AHFS). Injury 2016;47:2138-2143.
APA timur o, Karaşahin Ö, KARAMAN E, Serin B, URVASIZOĞLU T, AKGOL GUR S, Sevinc C (2021). Factors Associated with Mortality in Geriatric Patients Presenting to the Emergency Department After Falls. , 171 - 176. 10.4274/ejgg.galenos.2021.2021-4-1
Chicago timur ozge,Karaşahin Ömer,KARAMAN Eda URAL,Serin Bilge Nur,URVASIZOĞLU Taha Burak,AKGOL GUR Sultan Tuna,Sevinc Can Factors Associated with Mortality in Geriatric Patients Presenting to the Emergency Department After Falls. (2021): 171 - 176. 10.4274/ejgg.galenos.2021.2021-4-1
MLA timur ozge,Karaşahin Ömer,KARAMAN Eda URAL,Serin Bilge Nur,URVASIZOĞLU Taha Burak,AKGOL GUR Sultan Tuna,Sevinc Can Factors Associated with Mortality in Geriatric Patients Presenting to the Emergency Department After Falls. , 2021, ss.171 - 176. 10.4274/ejgg.galenos.2021.2021-4-1
AMA timur o,Karaşahin Ö,KARAMAN E,Serin B,URVASIZOĞLU T,AKGOL GUR S,Sevinc C Factors Associated with Mortality in Geriatric Patients Presenting to the Emergency Department After Falls. . 2021; 171 - 176. 10.4274/ejgg.galenos.2021.2021-4-1
Vancouver timur o,Karaşahin Ö,KARAMAN E,Serin B,URVASIZOĞLU T,AKGOL GUR S,Sevinc C Factors Associated with Mortality in Geriatric Patients Presenting to the Emergency Department After Falls. . 2021; 171 - 176. 10.4274/ejgg.galenos.2021.2021-4-1
IEEE timur o,Karaşahin Ö,KARAMAN E,Serin B,URVASIZOĞLU T,AKGOL GUR S,Sevinc C "Factors Associated with Mortality in Geriatric Patients Presenting to the Emergency Department After Falls." , ss.171 - 176, 2021. 10.4274/ejgg.galenos.2021.2021-4-1
ISNAD timur, ozge vd. "Factors Associated with Mortality in Geriatric Patients Presenting to the Emergency Department After Falls". (2021), 171-176. https://doi.org/10.4274/ejgg.galenos.2021.2021-4-1
APA timur o, Karaşahin Ö, KARAMAN E, Serin B, URVASIZOĞLU T, AKGOL GUR S, Sevinc C (2021). Factors Associated with Mortality in Geriatric Patients Presenting to the Emergency Department After Falls. European journal of geriatrics and gerontology (Online), 3(3), 171 - 176. 10.4274/ejgg.galenos.2021.2021-4-1
Chicago timur ozge,Karaşahin Ömer,KARAMAN Eda URAL,Serin Bilge Nur,URVASIZOĞLU Taha Burak,AKGOL GUR Sultan Tuna,Sevinc Can Factors Associated with Mortality in Geriatric Patients Presenting to the Emergency Department After Falls. European journal of geriatrics and gerontology (Online) 3, no.3 (2021): 171 - 176. 10.4274/ejgg.galenos.2021.2021-4-1
MLA timur ozge,Karaşahin Ömer,KARAMAN Eda URAL,Serin Bilge Nur,URVASIZOĞLU Taha Burak,AKGOL GUR Sultan Tuna,Sevinc Can Factors Associated with Mortality in Geriatric Patients Presenting to the Emergency Department After Falls. European journal of geriatrics and gerontology (Online), vol.3, no.3, 2021, ss.171 - 176. 10.4274/ejgg.galenos.2021.2021-4-1
AMA timur o,Karaşahin Ö,KARAMAN E,Serin B,URVASIZOĞLU T,AKGOL GUR S,Sevinc C Factors Associated with Mortality in Geriatric Patients Presenting to the Emergency Department After Falls. European journal of geriatrics and gerontology (Online). 2021; 3(3): 171 - 176. 10.4274/ejgg.galenos.2021.2021-4-1
Vancouver timur o,Karaşahin Ö,KARAMAN E,Serin B,URVASIZOĞLU T,AKGOL GUR S,Sevinc C Factors Associated with Mortality in Geriatric Patients Presenting to the Emergency Department After Falls. European journal of geriatrics and gerontology (Online). 2021; 3(3): 171 - 176. 10.4274/ejgg.galenos.2021.2021-4-1
IEEE timur o,Karaşahin Ö,KARAMAN E,Serin B,URVASIZOĞLU T,AKGOL GUR S,Sevinc C "Factors Associated with Mortality in Geriatric Patients Presenting to the Emergency Department After Falls." European journal of geriatrics and gerontology (Online), 3, ss.171 - 176, 2021. 10.4274/ejgg.galenos.2021.2021-4-1
ISNAD timur, ozge vd. "Factors Associated with Mortality in Geriatric Patients Presenting to the Emergency Department After Falls". European journal of geriatrics and gerontology (Online) 3/3 (2021), 171-176. https://doi.org/10.4274/ejgg.galenos.2021.2021-4-1