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BMC Health Services Research
Published in: BMC Health Services Research 1/2013

Open Access 01-12-2013 | Research article

Risk factors associated with visiting or not visiting the accident & emergency department after a fall

Authors: Alice C Scheffer, Pieter Boele van Hensbroek, Nynke van Dijk, Jan S K Luitse, Johannes C Goslings, René H Luigies, Sophia E de Rooij

Published in: BMC Health Services Research | Issue 1/2013

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Abstract

Background

Little is known about the prevalence of modifiable risk factors of falling in elderly persons with a fall-history who do not visit the Accident and Emergency (A&E) Department after one or more falls. The objective of this study was to determine the prevalence of modifiable risk factors in a population that visited the A&E Department after a fall (A&E group) and in a community-dwelling population of elderly individuals with a fall history who did not visit the A&E Department after a fall (non-A&E group).

Methods

Two cohorts were included in this study. The first cohort included 547 individuals 65 years and older who were visited at home by a mobile fall prevention team. The participants in this cohort had fall histories but did not visit the A&E Department after a previous fall. These participants were age- and gender-matched to persons who visited the A&E Department for care after a fall. All participants were asked to complete the CAREFALL Triage Instrument.

Results

The mean number of modifiable risk factors in patients who did not visit the A&E Department was 2.9, compared to 3.8 in the group that visited the A&E Department (p<0.01). All risk factors were present in both groups but were more prevalent in the A&E group, except for the risk factors of balance and mobility (equally prevalent in both groups) and orthostatic hypotension (less prevalent in the A&E group). The risk factors of polypharmacy, absence of orthostatic hypotension, fear of falling, impaired vision, mood and high risk of osteoporosis were all independently associated with visiting the A&E Department.

Conclusion

All modifiable risk factors for falling were found to be shared between community-dwelling elderly individuals with a fall history who visited the A&E Department and those who did not visit the Department, although the prevalence of these factors was somewhat lower in the A&E group. Preventive strategies aimed both at patients presenting to the A&E Department after a fall and those not presenting after a fall could perhaps reduce the number of recurrent falls, the occurrence of injury and the frequency of visits to the A&E Department.
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Metadata
Title
Risk factors associated with visiting or not visiting the accident & emergency department after a fall
Authors
Alice C Scheffer
Pieter Boele van Hensbroek
Nynke van Dijk
Jan S K Luitse
Johannes C Goslings
René H Luigies
Sophia E de Rooij
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2013
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/1472-6963-13-286

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