Emergency Department Perspective on Geriatric Patients Presenting with Fall Complaints

Year 2024, Volume: 15 Issue: 2, 182 - 189, 01.07.2024

Nezih Kavak Nurgül Balcı

https://doi.org/10.18663/tjcl.1455184

Abstract

Aims: Geriatric falls represent a rapidly growing public health concern worldwide. This study aims to evaluate geriatric patients presenting to the emergency department (ED) due to falls.
Materials and Methods: In this retrospective cross-sectional study, patients aged 65 and over who presented to the ED due to falls were evaluated in terms of age, gender, marital status, month of presentation, time of presentation, history of falls within the last year, manner of arrival, affected body region, departments consulted, radiological examinations conducted, previous history of falls, past medical history, hospitalization status, and mortality.
Results: Of the 1080 patients, 718 (66.48%) were female, with a median age of 77.00 (range 65-102). The patients were classified into two groups based on age; those between 65-74 years old as group 1, and those aged 75 and above as group 2. Group 1 comprised 435 patients (40.28%), while the group 2 included 645 patients (59.72%). 49.07% of the patients were married, and 47.87% were divorced/widowed. Among those divorced/widowed, 57.52% were above 75 years of age. Significant statistical associations were found between age groups and marital status, and between gender and marital status (p=0.000 for both). The most common complaints following a fall were related to the head-neck (21.35%) and leg-knee (16.64%) regions.
Conclusion: Our study indicates that age, gender, and marital status are significant risk factors in determining strategies related to falls in the elderly.

Keywords

Fall, geriatrics, gender, marital status

Ethical Statement

This study adhered to the Helsinki Declaration guidelines, securing approval from the Etlik City Hospital ethical committee (2023/485).

Acil Servise Düşme Şikâyeti ile Başvuran Geriatrik Hastalara Bakış

Abstract

Amaç: Geriatrik düşme dünya çapında hızla büyüyen bir halk sağlığı sorunudur. Bu çalışmanın amacı acil servise (AS) düşme nedeniyle başvuran geriatrik hastaları değerlendirmektir.
Gereç ve Yöntemler: Bu retrospektif kesitsel tipte çalışmada, AS e düşme nedeniyle başvuru yapan 65 yaş ve üstü hastaların yaşı, cinsiyeti, medeni hali, başvuru ayı, başvuru saati, son bir yıl içinde düşme hikayesi, geliş şekli, etkilenen vücut bölgesi, konsültasyon istenen birimler, yapılan radyolojik tetkikler, eski düşme öyküsü, özgeçmişindeki hastalıkları, yatış durumu ve mortalite değerlendirildi.
Bulgular: 1080 hastanın 718’i (%66,48) kadın, ortanca yaşı 77.00 (65-102) idi. Hastalar yaşlarına göre; 65-74 yaş aralığında olanlar grup 1 ve 75 yaş ve üstünde olanlar ise grup 2 olarak sınıflandırıldı. Grup 1 (65-74 yaş) hasta sayısı 435 (%40,28) iken grup 2 (75 yaş ve üstü) hasta sayısı 645 (%59.72) idi. Hastaların %49,07’si evli, %47.87’si ise boşanmış/dul idi. Boşanmış/dul olanların 75 yaş üstünde %57,52 oranındaydı. Yaş grupları ile medeni hal, cinsiyet ile medeni hal arasında istatistiksel olarak anlamlı sonuç bulundu (sırasıyla p=0.000, p=0.000). Hastaların düşme sonucunda şikayetleri en sık baş-boyun (%21,35) ve bacak-diz (%16,64) bölgelerinde idi.
Sonuç: Çalışmamız yaşlılarda düşme ile ilişkin stratejilerin belirlenmesi için yaş, cinsiyet ve medeni durumun risk faktörü olarak önemli olduğunu göstermektedir.

Keywords

Düşme, geriatri, cinsiyet, medeni durum

References

• Falls, Key facts. World Health Organization;2021. Available from: https://www.who.int/news-room/fact-sheets/detail/falls Accessed Jan 01, 2024.
• Step safely: strategies for preventing and managing falls across the life-course. Geneva:WHO; 2021. Licence: CC BY-NC-SA 3.0 IGO.
• Alfrey EJ, Carroll M, Tracy M, Pajari L, Bason-Mitchell M, Alfrey JR, et al. Increase in trauma volume as compared to emergency department volume during the COVID-19 pandemic. Injury. 2023;54(7):110758.
• WHO. Global Report on Falls Prevention in Older Age. WHO (2017). ISBN 978 92 4 156353 6. www.who.int/ageing/en.
• Appeadu MK, Bordoni B. Falls and Fall Prevention in Older Adults. [Updated 2023 Jun 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK560761/.
• Çelik P, Çelik Ş, Hastaoğlu F. Acil Servis Başvuran Geriatrik Hasta Profilinin Belirlenmesi. JoGS. 2022;5(3):72-80.
• Ulusoylar N., Dost Günay FS, Dokuzlar Ö, Koç Okudur S. Geriatrik Sendromlarda Düşme Sıklığı. GBD. 2019;2(1):8-13
• Gökçek MB, Gökçek İ, Yılmaz T, Kasım İ, Yılmaz TE, Özkara A. Düşme Şikâyeti ile Acil Servise Başvuran 65 Yaş Üzeri ve Hastaların Düşme Nedenleri ve Risk Faktörlerinin Araştırılması. Konuralp Tıp Dergisi. 2019;11(2):217-26.
• Kamel MH, Abdulmajeed AA, Ismail Sel-S. Risk factors of falls among elderly living in urban Suez--Egypt. Pan Afr Med J. 2013; 14:26.
• Gale CR, Cooper C, Aihie Sayer A. Prevalence and risk factors for falls in older men and women: The English Longitudinal Study of Ageing. Age Ageing. 2016;45(6):789-794.
• Chang VC, Do MT. Risk factors for falls among seniors: implications of gender. Am J Epidemiol. 2015;181(7):521-31.
• Baykan N, Durukan P, Salt O, Yakar S, Kantar Y, Kaymaz ND, et al.. Examination of Geriatric Trauma Patients Presenting to the Emergency Department. Phoenix Medical Journal. 2022;4(1):22-6.
• Erdem Ö, Atay S. Acil Servise Başvuran Bireylerde Düşme Riski ve Etkileyen Faktörlerin İncelenmesi. HUHEMFAD. 2018;5(2):128-37.
• Tang S, Liu M, Yang T, Ye C, Gong Y, Yao L, et al. Association between falls in elderly and the number of chronic diseases and health-related behaviors based on CHARLS 2018: health status as a mediating variable. BMC geriatrics. 2022; 22:374.
• Li Y, Hou L, Zhao H, Xie R, Yi Y, Ding X. Risk factors for falls among community-dwelling older adults: A systematic review and meta-analysis. Front Med (Lausanne). 2023; 9:1019094. Published 2023 Jan 6.
• Komisar V, Dojnov A, Yang Y, Shishov N, Chong H, Yu Y, et al. Injuries from falls by older adults in long-term care captured on video: Prevalence of impacts and injuries to body parts. BMC geriatrics. 2022; 22:343.
• Ahmedov Y, Ahmedov A. Acil Serviste Yatan Hastaların Düşme Risklerinin Belirlenmesi. EGEHFD, 37(3), 2021.207-16.
• Moncada LVV, Mire LG. Preventing Falls in Older Persons. Am Fam Physician. 2017; 96:240-7.
• Blain H, Miot S, Bernard PL. How Can We Prevent Falls? In: Falaschi P, Marsh D, editors. Orthogeriatrics: The Management of Older Patients with Fragility Fractures. Cham (CH): Springer Copyright 2021, The Author(s). 2021. p. 273-90.
• Foote CW, Vanier C, Chen C, Palacio CH. Evaluation of therapy in traumatic elderly falls to return autonomy and functional status. Surgery Open Science. 2022; 10:174-81.
• Salari N, Darvishi N, Ahmadipanah M, Shohaimi S, Mohammadi M. Global prevalence of falls in the older adults: a comprehensive systematic review and meta-analysis. J Orthop Surg Res. 2022; 17:334.
• Montero-Odasso M, van der Velde N, Martin FC, Petrovic M, Tan MP, Ryg J, et al. World guidelines for falls prevention and management for older adults: a global initiative. Age and ageing. 2022; 51.
• Al-Aama T. Falls in the elderly: spectrum and prevention. Can Fam Physician. 2011; 57:771-6.