Evidence map›Paper›PMID 38960969›Full record

Observational studyInternal and emergency medicine2025

Nonspecific stress biomarkers for mortality prediction in older emergency department patients presenting with falls: a prospective multicenter observational study.

Lukas Terhalle, Laura Arntz, Felix Hoffmann, Isabelle Arnold, Livia Hafner, Laurentia Picking-Pitasch, Joanna Zuppinger, Karen Delport Lehnen, Jörg Leuppi, Rajan Somasundaram and 2 more

Registry-linked trialAbstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Internal and emergency medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02244983 (Falls Of Unknown Origin), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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.

NCT02244983 completednot on this map

Falls Of Unknown Origin (FUKNO) - Are Morbidity and Mortality Predictable in Patients Presenting With Falls?

Typeobservational_patient_registrySponsorUniversity Hospital, Basel, SwitzerlandRan2014 to 2021Enrolled587ConditionsAccidental Falls, Underlying Disease of FallsArmsPatients History
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

12 authors.

Lukas TerhalleEmergency Department, University Hospital Basel, University of Basel, Basel, Switzerland. lukas.terhalle@usb.ch.ORCID 0000-0002-8809-2880
Laura ArntzEmergency Department, Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Felix HoffmannEmergency Department, University Hospital Basel, University of Basel, Basel, Switzerland.
Isabelle ArnoldEmergency Department, University Hospital Basel, University of Basel, Basel, Switzerland.
Livia HafnerEmergency Department, University Hospital Basel, University of Basel, Basel, Switzerland.
Laurentia Picking-PitaschEmergency Department, University Hospital Basel, University of Basel, Basel, Switzerland.
Joanna ZuppingerEmergency Department, University Hospital Basel, University of Basel, Basel, Switzerland.
Karen Delport LehnenEmergency Department, Cantonal Hospital Basel-Landschaft Campus Bruderholz, Binningen, Switzerland.
Jörg LeuppiMedical Faculty, University of Basel and Cantonal Hospital Baselland, Liestal, Switzerland.
Rajan SomasundaramEmergency Department, Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Christian H NickelEmergency Department, University Hospital Basel, University of Basel, Basel, Switzerland.
Roland BingisserEmergency Department, University Hospital Basel, University of Basel, Basel, Switzerland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundOlder patients presenting to the emergency department (ED) after falling are increasingly prevalent. Falls are associated with functional decline and death. Biomarkers predicting short-term mortality might facilitate decisions regarding resource allocation and disposition. D-dimer levels are used to rule out thromboembolic disease, while copeptin and adrenomedullin (MR-proADM) may be used as measures of the patient`s stress level. These nonspecific biomarkers were selected as potential predictors for mortality.

methodsProspective, international, multicenter, cross-sectional observation was performed in two tertiary and two regional hospitals in Germany and Switzerland. Patients aged 65 years or older presenting to the ED after a fall were enrolled. Demographic data, Activities of Daily Living (ADL), and D-dimers were collected upon presentation. Copeptin and MR-proADM levels were determined from frozen samples. Primary outcome was 30-day mortality; and secondary outcomes were mortality at 90, 180, and 365 days.

resultsFive hundred and seventy-two patients were included. Median age was 83 [IQR 78, 89] years, 236 (67.7%) were female. Mortality overall was 3.1% (30 d), 5.4% (90 d), 7.5% (180 d), and 13.8% (365 d), respectively. Non-survivors were older, had a lower ADL index and higher levels of all three biomarkers. Elevated levels of MR-proADM and D-dimer were associated with higher risk of mortality. MR-proADM and D-dimer showed high sensitivity and low negative likelihood ratio regarding short-term mortality, whereas copeptin did not.

conclusionD-dimer and MR-proADM levels might be useful as prognostic markers in older patients presenting to the ED after a fall, by identifying patients at low risk of short-term mortality.

trial registrationClinicalTrials.gov Identifier: NCT02244983.

Indexed as

Accidental FallsBiomarkersMortalityAdrenomedullinAgedAged, 80 and overCross-Sectional StudiesEmergency Service, HospitalFemaleFibrin Fibrinogen Degradation ProductsGermanyGlycopeptidesHumansMalePeptide FragmentsProspective StudiesAdrenomedullinBiomarkerscopeptinsFibrin Fibrinogen Degradation Productsfibrin fragment DGlycopeptidesPeptide FragmentsAdrenomedullinBiomarkersCopeptinD-dimerEmergency departmentMortality prediction

Identifiers

PMID38960969
PMCPMC11950067

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Registered trials

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.