Falls associated with higher rate of adverse events than previously thought

Newly published research offers a reason for more urgency for the prevention of falls in senior living residents and other older adults.

The investigators found that 50.3% of adults aged 65 or more years who visited an emergency department because they were injured in a fall experienced adverse events — including additional falls, hospitalization or death — within six months after the visit. Their findings were published online Wednesday in the journal Annals of Emergency Medicine.

“Our study shows an even higher rate of adverse events than previous studies have,” said lead study author Jiraporn Sri-on, M.D.

Each of the study’s five authors was affiliated with the ED of a Boston-area hospital — Massachusetts General Hospital, Spaulding Rehabilitation Hospital or Beth Israel Deaconess Medical Center. They studied data from older adults who had visited the ED of an unnamed urban teaching hospital because of a fall in 2012.

The study included 350 older adults, 43 of whom were assisted living residents and six of whom lived in skilled nursing facilities. Study participants’ median age was 81.

Of older adults who visited the ED for injuries due to a fall, 7.7% experienced other adverse events within seven days, 21.4% developed them within 30 days and 50.3% had other adverse events within six months.

Within six months, 22.6% had fallen at least once, 42.6% had revisited the ED, 31.1% had been hospitalized and 2.6% had died.

“Patients taking psychiatric and/or sedative medications had even more adverse events,” Sri-on said. “This is concerning because these types of drugs are commonly prescribed for elderly patients in community and residential care settings.”

Other risk factors associated with adverse events within six months of an ED visit for a fall, the authors said, included diabetes and polypharmacy (in this case, taking five or more medications).

The authors recommend medication management, and they also suggested falls-prevention education of older adults by ED physicians who treat them on visits because of falls.