Falls and frailty in the emergency department short stay unit

• Published in: Asian journal of gerontology and geriatrics Vol. 15; no. 2; p. 108
• Main Authors: Rosario, Barbara H, Yi-En, Clara Seah, Barrer, Vivian Cantiller, Yu, Koh Xin, Hock, Arron Ang Seng
• Format: Journal Article
• Language: English
• Published: Hong Kong Hong Kong Academy of Medicine 01.12.2020
• Subjects: Frailty; Geriatrics; Osteoporosis
• ISSN: 1819-1576; 1819-1576

Background: One third of community dwellers aged >65 years fall each year, and half of those who have fallen will fall again. This study aimed to introduce a falls protocol to improve outcomes by early identification of frailty, optimisation of bone health, and modification of risk factors. Methods: Records of 102 patients aged >65 years who were admitted to an emergency department short stay unit between 10 March 2019 and 10 October 2019 and completed a comprehensive geriatric assessment were retrospectively reviewed to assess the effectiveness of the fall service protocol. Frailty was determined using the Clinical Frailty Scale (CFS). Results: The mean age of the 62 female and 40 male patients was 80 (range, 65-96) years. 32% were first-time fallers; 1% had near fall; and 67% had prior falls. 22.8% of fallers were non-frail (CFS of 1-3); 15.8% were prefrail (CFS of 4); and 61.4% were frail (CFS of >5). Total (prior and index) falls occurred in 18.5% of non-frail, 10.5% of prefrail, and 71% of frail patients. 34.3% of patients were discharged home, with a 30-day unplanned readmission rate of 5.9%, whereas 13% were re-admitted with falls within 6 months. 29.4% of patients were diagnosed with unrecognised osteoporosis, whereas 22.5% were already diagnosed with osteoporosis and 20.6% with osteopenia. Conclusion: The emergency department short stay unit fall service can identify underlying frailty and geriatric syndromes so that preventive measures can be undertaken to reduce the risk of future injurious falls and osteoporotic fractures.