Lack of Fall Concern and Primary Care Physician Follow-Up in Geriatric Emergency Department Patients with Head Trauma from a Fall-Advances in Geriatric Medicine and Research-CSCIED科技核心评价数据库-手机版

Lack of Fall Concern and Primary Care Physician Follow-Up in Geriatric Emergency Department Patients with Head Trauma from a Fall

Lack of Fall Concern and Primary Care Physician Follow-Up in Geriatric Emergency Department Patients with Head Trauma from a Fall

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DOI	10.20900/agmr20250014
刊名	Advances in Geriatric Medicine and Research AGMR
年，卷(期)	2025, 7(3)
作者	Maya Khazem,Gabriella Engstrom,Mike Wells,Scott M. Alter,Lisa M. Clayton,Timothy P. Buckley,Joshua J. Solano,Patrick G. Hughes,Vibhor Agrawal,Richard D. Shih*,
作者单位	Charles E. Schmidt College of Medicine, Florida Atlantic University, FL 33431, USA ;
摘要	Background: Falls are the leading cause of fatal and nonfatal injuries in the United States for adults aged 65 years and older. The objective of this study was to determine the impact of patient self-perceived concern about falling on subsequent primary care provider (PCP) follow-up in older emergency department (ED) adults who sustained a head injury from a fall. Methods: This was a secondary analysis of a large prospective study which included patients aged ≥65 years who had sustained head trauma from a fall. Patients with penetrating injuries, injury >24 h prior to presentation, and transfer from another hospital were excluded. Participants were telephonically followed up 14 days after ED presentation. They were asked about their concern for a repeat fall and whether they had followed-up with their PCP since discharge. Results: Of 1527 participants surveyed, 769 (50.4%) were concerned about falling again and 758 (49.6%) were slightly or not at all concerned. There was an overall low PCP follow-up rate. The follow up rate was slightly higher for those concerned vs. not concerned about falling (62% vs 56%, p = 0.035; OR = 1.25, 95% CI: 1.01–1.53). Conclusions: Geriatric ED patients who suffered head injury from a fall and expressed concern about future falls were more likely to follow up with their PCP. Fifty percent of participants with a self-reported fall expressed little to no concern for falling again. This suggests that many ED patients that have fallen are vulnerable to deficient PCP follow-up and fall prevention strategies. We suggest increased physician and patient education to emphasize fall prevention and PCP follow-up.
Abstract	Background: Falls are the leading cause of fatal and nonfatal injuries in the United States for adults aged 65 years and older. The objective of this study was to determine the impact of patient self-perceived concern about falling on subsequent primary care provider (PCP) follow-up in older emergency department (ED) adults who sustained a head injury from a fall. Methods: This was a secondary analysis of a large prospective study which included patients aged ≥65 years who had sustained head trauma from a fall. Patients with penetrating injuries, injury >24 h prior to presentation, and transfer from another hospital were excluded. Participants were telephonically followed up 14 days after ED presentation. They were asked about their concern for a repeat fall and whether they had followed-up with their PCP since discharge. Results: Of 1527 participants surveyed, 769 (50.4%) were concerned about falling again and 758 (49.6%) were slightly or not at all concerned. There was an overall low PCP follow-up rate. The follow up rate was slightly higher for those concerned vs. not concerned about falling (62% vs 56%, p = 0.035; OR = 1.25, 95% CI: 1.01–1.53). Conclusions: Geriatric ED patients who suffered head injury from a fall and expressed concern about future falls were more likely to follow up with their PCP. Fifty percent of participants with a self-reported fall expressed little to no concern for falling again. This suggests that many ED patients that have fallen are vulnerable to deficient PCP follow-up and fall prevention strategies. We suggest increased physician and patient education to emphasize fall prevention and PCP follow-up.
关键词	fall; geriatric; head trauma; primary care physician; emergency department; follow up; fall prevention
KeyWord	fall; geriatric; head trauma; primary care physician; emergency department; follow up; fall prevention
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1.Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Web-based injury statistics query and reporting system (WISQARS)
[online]. Available from: https://wisqars.cdc.gov/. Accessed on 7 Apr 2024.

2.Moreland B, Kakara R, Henry A. Trends in nonfatal falls and fall-related injuries among adults aged ≥65 years—United States, 2012–2018. MMWR Morb Mortal Wkly Rep. 2020;69:875-81.

3.Florence CS, Bergen G, Atherly A, Burns ER, Stevens JA, Drake C. Medical costs of fatal and nonfatal falls in older adults. J Am Ger Soc. 2018;66:693-8.

4.Bhasin S, Gill TM, Reuben DB, Latham NK, Ganz DA, Greene EJ, et al. A randomized trial of a multifactorial strategy to prevent serious fall injuries. N Engl J Med. 2020;383:129-40.

5.Goldberg EM, Marks SJ, Resnik LJ, Long S, Mellott H, Merchant RC. Can an emergency department-initiated intervention prevent subsequent falls and health care use in older adults? A randomized controlled trial. Ann Emerg Med. 2020;76(6):739-50.

6.Twibell RS, Siela D, Sproat T, Coers G. Perceptions related to falls and fall prevention among hospitalized adults. Am J Crit Care. 2015;24(5):e78-85. doi: 10.4037/ajcc2015375.

7.Shih RD, Solano JJ, Engstrom G, Khazem M, Clayton LM, Wells M, et al. Lack of patient and primary care physician follow-up in geriatric emergency department patients with head trauma from a fall. Am J Emerg Med. 2024;75:29-32.

8.Rogers RW. A protection motivation theory of fear appeals and attitude change1. J Psychol. 1975;91:93-114.

9.Stevens JA, Phelan EA. Development of STEADI: A fall prevention resource for health care providers. Health Promot Pract. 2013;14:706-14.

10.Shankar KN, Treadway NJ, Taylor AA, Breaud AH, Peterson EW, Howland J. Older adult falls prevention behaviors 60 days post-discharge from an urban emergency department after treatment for a fall. Inj Epidemiol. 2017;4:18.

11.Meimandi M, Fadavi-Ghaffari M, Taghizadeh G, Azad A, Lajevardi L. Falls efficacy scale and single item question: Screening accuracy for older adults residing in nursing homes. Clin Gerontol. 2021;44(5):544-51. doi: 10.1080/07317115.2020.1858467.

12.Friedman SM, Munoz B, West SK, Rubin GS, Fried LP. Falls and fear of falling: Which comes first? A longitudinal prediction model suggests strategies for primary and secondary prevention. J Am Geriatr Soc. 2002;50(8):1329-35.

13.Jones TS, Ghosh TS, Horn K, Smith J, Vogt RL. Primary care physiciansʼ perceptions and practices regarding fall prevention in adultʼs 65 years and over. Accid Anal Prev. 2011;43:1605-9.

14.Greenberg SA, Sullivan-Marx E, Sommers ML, Chittams J, Cacchione PZ. Measuring fear of falling among high-risk, urban, community-dwelling older adults. Geriatr Nurs. 2016;37(6):489-95. doi: 10.1016/j.gerinurse.2016.08.018.

15.Belloni G, Büla C, Santos-Eggimann B, Henchoz Y, Seematter-Bagnoud L. A single question as a screening tool to assess fear of falling in young-old community-dwelling persons. J Am Med Dir Assoc. 2020;21(9):1295-1301.e2. doi: 10.1016/j.jamda.2020.01.101.

16.US Department of Health and Human Services. 2012 Annual Progress Report to Congress: National Strategy for Quality Improvement in Health Care. Available from: http://www.ahrq.gov/workingforquality/nqs/nqs2012annlrpt.pdf. Accessed on 3 Nov 2024.

17.Sonnad SS, Mascioli S, Cunningham J, Goldsack J. Do patients accurately perceive their fall risk? Nursing. 2014;44:58-62.

18.McMahon S, Talley KM, Wyman JF. Older people’s perspectives on fall risk and fall prevention programs: A literature review. Int J Older People Nurs. 2011;6:289-98.

19.Merchant RA, Wojszel ZB, Ryg J. The hidden impact of mild-traumatic brain injury in older adults. Eur Geriatr Med. 2024;15:1551-4.

20.Reyes B, Ouslander JG. Care transitions programs for older adults—a worldwide need. European Geriatr Med. 2019;10:387-93.

21.CDC. Patient & Caregiver Resources. STEADI—Older Adult Fall Prevention. Available from: https://www.cdc.gov/steadi/patient-resources/index.html. Accessed on 15 Sept. 2023

22.Panel on Prevention of Falls in Older Persons, American Geriatrics Society and British Geriatrics Society. Summary of the updated American Geriatrics Society/British Geriatrics Society clinical practice guideline for prevention of falls in older persons. J Am Geriatr Soc. 2011;59:148-57.

23.Grossman DC, Curry SJ, Owens DK, Barry MJ, Caughey AB, Davidson KW, et al. Interventions to prevent falls in community-dwelling older adults: US Preventive Services Task Force recommendation statement. JAMA. 2024;332:51-7.

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Maya Khazem,Gabriella Engstrom,Mike Wells,Scott M. Alter,Lisa M. Clayton,Timothy P. Buckley,Joshua J. Solano,Patrick G. Hughes,Vibhor Agrawal,Richard D. Shih*. Lack of Fall Concern and Primary Care Physician Follow-Up in Geriatric Emergency Department Patients with Head Trauma from a Fall [J]. Advances in Geriatric Medicine and Research. 2025; 7; (3). - .

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