Emergency department revisits and hospital readmissions following a fall-related emergency department presentation in older adults: a systematic review and meta-analysis.

Abstract

Background: Falls are a leading cause of emergency department (ED) visits in older adults, yet subsequent trajectories of acute care use remain poorly characterised. We aimed to estimate pooled proportions of ED revisits and hospital readmissions at multiple follow-up intervals within 1 year.

Methods: In this systematic review and meta-analysis (PROSPERO: CRD420251167449), we searched PubMed, Embase and Scopus from inception to 30 November 2025 for observational studies including adults aged ≥65 years presenting to the ED after an index fall. Eligible studies reported ED revisits and/or hospital readmissions within 1 year. Two reviewers independently screened studies, extracted data and assessed risk of bias using the Newcastle-Ottawa Scale. Random-effects meta-analyses of proportions were conducted for each follow-up interval.

Results: Nineteen studies (20 publications) were included, with overall low to moderate risk of bias. The cumulative proportions of patients experiencing an ED revisit increased with longer follow-up, from 3.9% within 3 days to 8.8% within 7 days, 15.0% within 30 days and 21.7% within 90 days (single study), reaching 37.5% at 6 months and 41.3% at 12 months. Hospital readmissions similarly increased from 10.4% at 30 days to 30.4% at 6 months and 31.9% at 12 months (single study). Substantial heterogeneity was observed across several pooled analyses.

Conclusion: A fall-related ED presentation is associated with substantial cumulative acute care use over the following year. Falls may represent an important marker of broader vulnerability and ongoing healthcare needs. Future research should identify patients at high risk of recurrent acute care use and determine whether targeted follow-up reduces recurrent ED visits and hospital readmissions.