Evidence map›Paper›PMID 33663559›Full record

ArticleScandinavian journal of trauma, resuscitation and emergency medicine2021

Geriatric screening, fall characteristics and 3- and 12 months adverse outcomes in older patients visiting the emergency department with a fall.

Laura C Blomaard, Simon P Mooijaart, Leonie J van Meer, Julia Leander, Jacinta A Lucke, Jelle de Gelder, Sander Anten, Jacobijn Gussekloo, Bas de Groot

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Scandinavian journal of trauma, resuscitation and emergency medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Laura C BlomaardDepartment of Internal Medicine, section Geriatrics, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, The Netherlands. l.c.blomaard@lumc.nl.ORCID http://orcid.org/0000-0002-2119-9464
Simon P MooijaartDepartment of Internal Medicine, section Geriatrics, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, The Netherlands.
Leonie J van MeerDepartment of Internal Medicine, section Geriatrics, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, The Netherlands.
Julia LeanderDepartment of Internal Medicine, section Geriatrics, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, The Netherlands.
Jacinta A LuckeDepartment of Emergency Medicine, Spaarne Gasthuis, Haarlem, The Netherlands.
Jelle de GelderDepartment of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands.
Sander AntenDepartment of Internal Medicine, section Acute Care, Alrijne Hospital, Leiderdorp, The Netherlands.
Jacobijn GusseklooDepartment of Internal Medicine, section Geriatrics, Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, The Netherlands.
Bas de GrootDepartment of Emergency Medicine, Leiden University Medical Center, Leiden, The Netherlands.

Funding

ZonMw 62700.3001ZonMw 62700.4001
6 · The paper itself

Abstract

backgroundFalls in older Emergency Department (ED) patients may indicate underlying frailty. Geriatric follow-up might help improve outcomes in addition to managing the direct cause and consequence of the fall. We aimed to study whether fall characteristics and the result of geriatric screening in the ED are independently related to adverse outcomes in older patients with fall-related ED visits.

methodsThis was a secondary analysis of the observational multicenter Acutely Presenting Older Patient (APOP) study, of which a subset of patients aged ≥70 years with fall-related ED visits were prospectively included in EDs of two Dutch hospitals. Fall characteristics (cause and location) were retrospectively collected. The APOP-screener was used as a geriatric screening tool. The outcome was 3- and 12-months functional decline and mortality. We assessed to what extent fall characteristics and the geriatric screening result were independent predictors of the outcome, using multivariable logistic regression analysis.

resultsWe included 393 patients (median age 80 (IQR 76-86) years) of whom 23.0% were high risk according to screening. The cause of the fall was extrinsic (49.6%), intrinsic (29.3%), unexplained (6.4%) or missing (14.8%). A high risk geriatric screening result was related to increased risk of adverse outcomes (3-months adjusted odds ratio (AOR) 2.27 (1.29-3.98), 12-months AOR 2.20 (1.25-3.89)). Independent of geriatric screening result, an intrinsic cause of the fall increased the risk of 3-months adverse outcomes (AOR 1.92 (1.13-3.26)) and a fall indoors increased the risk of 3-months (AOR 2.14 (1.22-3.74)) and 12-months adverse outcomes (AOR 1.78 (1.03-3.10)).

conclusionsA high risk geriatric screening result and fall characteristics were both independently associated with adverse outcomes in older ED patients, suggesting that information on both should be evaluated to guide follow-up geriatric assessment and interventions in clinical care.

Indexed as

Accidental FallsEmergency Service, HospitalGeriatric AssessmentOutcome Assessment, Health CareAgedAged, 80 and overFemaleHumansMaleRetrospective StudiesRisk AssessmentAgedFallsFrailtyGeriatric emergency medicineOlder adults

Identifiers

PMID33663559
PMCPMC7934471

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.