• Am J Emerg Med · Jan 2024

    Observational Study

    Lack of patient and primary care physician follow-up in geriatric emergency department patients with head trauma from a fall.

    • Richard D Shih, Joshua J Solano, Gabriella Engstrom, Maya Khazem, Lisa M Clayton, Michael Wells, Patrick G Hughes, Leila Posaw, Lara Goldstein, Charles H Hennekens, Joseph G Ouslander, and Scott M Alter.
    • Florida Atlantic University, Charles E. Schmidt College of Medicine, United States of America; Depatment of Emergency Medicine, Delray Medical Center, United States of America. Electronic address: rshih@health.fau.edu.
    • Am J Emerg Med. 2024 Jan 1; 75: 293229-32.

    Study ObjectiveFalls 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.MethodsThis 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.ResultsOf 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.ConclusionOnly 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.Copyright © 2023 Elsevier Inc. All rights reserved.

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