Comparison of Risk Factors for Falls in the Old and the Oldest Old Admitted to the Emergency Department

Bahar Bektan Kanat, O. Incealtin
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Abstract

Background: Falls can cause a wide range of consequences from a simple injury to life-threatening situations. As falls are a major cause of mortality and morbidity in older adults, it is important to identify risk factors. Our aim was to evaluate fall risk factors in geriatric patients presenting to the emergency department with fall and to evaluate the variability of fall risk factors in the group below and above 85 years of age (oldest old). Materials and Methods: A total of 132 geriatric patients admitted to the emergency department of a univer-sity hospital due to falls were retrospectively analysed. Demographic characteristics and chronic diseases of patients, number of drugs, previous fall history, unintentional weight loss, depressive symptoms, anaemia, urinary incontinence, fear of falling, orthostatic hypotension were recorded. Edmonton frail scale, clock-draw-ing test and geriatric depression scale score was also evaluated. Results: The mean age of our study population was 80.5 ±8.3. While 80 (60.6%) of the patients were below 85 years of age, 52 (39.4%) were aged 85 years and older. 62 (47%) of the patients were frail and orthostatic hypotension was found in 10 (7.6%) of the patients. Fear of falling was observed in 67 (50.8%) patients. Polypharmacy was present in 62 (47%) patients. Frequency of diabetes mellitus, frailty, fear of falling, walking aid usage and the need for a regular caregiver were significantly higher and clock-drawing test score was lower in the oldest old group (p<0.05, for all). Conclusions: Falls are common in older patients. Our study clearly revealed the frequency of fall risk factors in the geriatric population admitted to the emergency department. The frequency of frailty was higher in the oldest old (over 85 years old) who presented with falls, and fear of falling was found in these patients even if there was no previous history of falling. Necessary precautions should be taken considering the negative con-sequences of falls.
急诊科老年人与老年老年人跌倒危险因素的比较
背景:跌倒可造成各种各样的后果,从简单的伤害到危及生命的情况。由于跌倒是老年人死亡和发病的主要原因,因此确定危险因素非常重要。我们的目的是评估因跌倒而到急诊科就诊的老年患者的跌倒危险因素,并评估85岁以下和85岁以上年龄组(最年长的老年人)跌倒危险因素的变异性。材料与方法:回顾性分析一所大学附属医院急诊收治的132例因跌倒的老年患者。记录患者的人口统计学特征和慢性疾病、用药次数、既往跌倒史、意外体重减轻、抑郁症状、贫血、尿失禁、害怕跌倒、体位性低血压。埃德蒙顿虚弱量表、钟画测试和老年抑郁量表评分也进行了评估。结果:研究人群的平均年龄为80.5±8.3岁。85岁以下80例(60.6%),85岁及以上52例(39.4%)。62例(47%)患者体弱,10例(7.6%)患者存在体位性低血压。67例(50.8%)患者有跌倒恐惧。62例(47%)患者存在多重用药。糖尿病、虚弱、害怕跌倒、使用助行器和需要定期照顾者的频率在老年组中显著较高,时钟绘制测试得分在老年组中显著较低(p<0.05)。结论:跌倒在老年患者中很常见。我们的研究清楚地揭示了急诊科收治的老年人群中跌倒危险因素的频率。出现跌倒的老年人(超过85岁)出现虚弱的频率更高,即使以前没有跌倒史,也会发现这些患者有跌倒恐惧。考虑到跌倒的负面后果,应该采取必要的预防措施。
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