RESEARCH PAPER
Fall as a cause of hospitalization in the Emergency Department in a population of people over 65 years of age
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1
Community Nursing Unit Chair of Oncology and Environmental Health, Medical University of Lublin, Poland
2
Department of Expert Medical Assistance with Emergency Medicine Unit, Medical University of Lublin, Poland
3
Department of Didactics and Medical Simulation, Medical University of Lublin, Poland
4
Department of Internal Medicine, Medical University of Lublin, Poland
5
Voivodship Emergency Ambulance Service, Lublin, Poland
Corresponding author
Grzegorz Nowicki
Community Nursing Unit Chair of Oncology and Environment Health Medical University, Lublin, Staszica, 20-153 Lublin, Poland
J Pre Clin Clin Res. 2015;9(2):115-119
KEYWORDS
ABSTRACT
Introduction:
Falls are included among the geriatric giants, as their consequences in older people are major in terms of nursing, medical, social and economic problems. In the case of elders they can lead to fractures and, consequently, even to death.
Material and Methods:
The study retrospectively analysed the medical records of 455 cases of injuries resulting from falls among patients over 65 years of age. Data was gathered in the Emergency Department (ER) of the Independent Public Clinical Hospital No. 1 in Lublin, Poland. The analysis included patients who visited the ER during the period 01.05.2009–30.04.2010.
Results:
Elderly patients hospitalized in the ER within the given period accounted for 8.10% of all patients. Most of patients over 65 years of age were admitted in December due to falls; slightly fewer cases were recorded in March and April. Mondays and Saturdays were the days of the week with the highest number of reports of elderly patients. Analysis of the collected data incorporating further treatment showed that the great majority of injured patients did not require hospitalization and were discharged home. In the analyzed population of older people, damage to upper and lower limbs dominated, followed by injuries to the head, chest and abdomen.
Conclusions:
Falls are a major cause of reduced quality of life, disability and death in older people. There are important factors in limb fractures (90%-100%). Preventing falls is a difficult and underestimated problem. There is a need of implementing preventative measures in the case of falls in elderly patients.
REFERENCES (25)
1.
Polish Main Statistical Office GUS. The population projection for the period 2008–2035. Warsaw: Main Statistical Office; 2008.
2.
Polish Main Statistical Office GUS. The report with the results. National Census of Population and Housing 2011. Warsaw: Main Statistical Office; 2012.
3.
Fuller GF. Falls in the elderly. Am Fam Physician. 2000; 61(7): 2159–68, 2173–4.
4.
Biercewicz M, Kędziora-Kornatowska K, Marzec A. Selected health problems in a population of elderly people. Ann Univ Mariae Curie Sklodowska [Med]. 2005; 30(Suppl XVI): 133–135 (in Polish, English abstract).
5.
Bosacka M, Jóźwiak A, Wieczorowska-Tobis K. Effect of previous falls on functional status of elderly subjects hospitalized at daily psychogeriatric unit. Geriatria. 2010; 4: 81–85 (in Polish, English abstract). Available at
http://www.akademiamedycyny.pl... archiwum/201002_geriatria_Wplyw%20przebytych%20upadkow%20 Bosacka.pdf. (accessed: 02.12.2014).
6.
Ostrowska B, Giemza C, Demczuk-Włodarczyk E, et al. Assessment of balance and gait in older nursing home residents. Physiotherapy. 2010; 18(4): 40–48.
7.
Runge M, Schacht E. Multifactorial pathogenesis of falls as a basis for multifactorial interventions. J Musculoskelet Neuronal Interact. 2005; 5(2): 127–134.
8.
Pruszyński J, Kuczerowska A. Falls. Polish Gerontology. 2004; 12(4): 177–181 (in Polish, English abstract).
9.
Imamura T. Hirono N, Hashimoto M, et al. Fall-related injuries in dementia with Lewy bodies (DLB) and Alzheimer’s disease. Eur J Neurol. 2000; 7(1): 77–79 (in Polish, English abstract).
10.
Sterling DA, O’Connor JA, Bonadies J. Geriatric falls: injury severity is high and disproportionate to mechanism. J Trauma. 2001; 50(1): 116–9.
11.
Gryglewska B. Elderly patient. Educational Program of the Polish Society of Hypertension. Polish Gerontology. 2003; 20(4): 119–147 (in Polish, English abstract).
12.
Rubenstain LZ. Falls in older people: epidemiology, risk factors and strategies for prevention. Age and Ageing. 2006; 35(Suppl 2): ii37–ii41.
14.
Chodorowski Z. Geriatrics – Advances in diagnosis and therapy. 1st ed. Gdynia: Grafica; 2007.
16.
Clinical practice guideline for the assessment and prevention of falls in older people. Guidelines commissioned by the National Institute for Clinical Exellence (NICE). Royal College of Nursing; 2004.
17.
Word Health Organization. Violence and Injury Prevention and Disability (VIP). France; 2007. Available at
http://www.who.int/violence_in..._ injury/falls/en/. (accessed: 20.08.2014).
18.
Czerwiński E, Kumorek A, Milert A, et al. Causes of falls among women in the population of Krakow. Orthopedics, Traumatology, Rehabilitation. 2008; 10(5): 429–440.
19.
Grochans E, Kardela B, Starczewska M, et al. The analysis of falls in patients hospitalized at geriatric ward. Hygeia Public Health. 2012; 47(3): 360–364. Available at
http://www.h-ph.pl/pdf/hyg-201.... (accessed: 2.12.2014).
20.
Żakowska-Wachelko B. Outline of geriatric medicine. 1st ed. Warsaw: Wydawnictwo Lekarskie PZWL, Warsaw; 2000.
21.
Pin Tan M, Kenny RA. Cardiovascular Assessment of Falls in Older People. Clin Intervent Aging. 2006; 1(1): 57–66.
22.
Miturski A, Zybińska S, Wardach K, et al. Analysis of the prevalence of fractures in people over 65 years of age. Emergency duty. 2011; 4(2): 55–62.
23.
Szczerbińska K. The circumstances and risk factors of recurrent and single falls in nursing homes. Polish Gerantology. 2011; 19(3–4): 161–170. Available at
http://czasopisma.viamedica.pl.... (accessed: 2.12.2014).
24.
Tinetti ME, Kumar Ch. The patient who falls. “It’s Always a Trade-off”. JAMA. 2010; 303(3): 258–266.
25.
Tinetti ME, Gordin C, Sogolow E, et al. Fall-risk evaluation and management: challenges in adopting geriatric care practices. Gerontologist. 2006; 46(6): 717–725.