• Jiraporn Sri-On, Gregory P Tirrell, Jonathan F Bean, Lewis A Lipsitz, and Shan W Liu.
• Emergency Department, Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand; Emergency Department, Massachusetts General Hospital, Boston, MA. Electronic address: jiraporn.rew@gmail.com.
• Ann Emerg Med. 2017 Oct 1; 70 (4): 516-521.e2.

Study ObjectiveWe seek to describe the risk during 6 months and specific risk factors for recurrent falls, emergency department (ED) revisits, subsequent hospitalizations, and death within 6 months after a fall-related ED presentation.MethodsThis was a secondary analysis of a retrospective cohort of elderly fall patients who presented to the ED from one urban teaching hospital. We included patients aged 65 years and older who had an ED fall visit in 2012. We examined the frequency and risk factors of adverse events (composite of recurrent falls, ED revisits, subsequent hospitalization, and death, selected a priori) at 6 months.ResultsOur study included 350 older adults. Adverse events steadily increased, from 7.7% at 7 days, 21.4% at 30 days, and 50.3% at 6 months. Within 6 months, 22.6% of patients had at least one recurrent fall, 42.6% revisited the ED, 31.1% had subsequent hospitalizations, and 2.6% died. In multivariable logistic regression analysis, psychological or sedative drug use predicted recurrent falls, ED revisits, subsequent hospitalizations, and adverse events.ConclusionMore than half of fall patients had an adverse event within 6 months of presenting to the ED after a fall. The risk during 6 months of these adverse events increased with psychological or sedative drug use. Larger future studies should confirm this association and investigate methods to minimize recurrent falls through management of such medications.Copyright © 2017 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

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