title: Frequency of ED revisits and death among older adults after a fall.
abstract: BACKGROUND
  Falls among older adults (aged ≥65 years) are the leading cause of both injury deaths and emergency department (ED) visits for trauma. We examine the characteristics and prevalence of older adult ED fallers as well as the recurrent ED visit and mortality rate.
  
  
  METHODS
  This was a retrospective analysis of a cohort of elderly fall patients who presented to the ED between 2005 and 2011 of 2 urban, level 1 trauma, teaching hospitals with approximately 80000 to 95000 annual visits. We examined the frequency of ED revisits and death at 3 days, 7 days, 30 days, and 1 year controlling for certain covariates.
  
  
  RESULTS
  Our cohort included 21340 patients. The average age was 78.6 years. An increasing proportion of patients revisited the ED over the course of 1 year, ranging from 2% of patients at 3 days to 25% at 1 year. Death rates increased from 1.2% at 3 days to 15% at 1 year. A total of 10728 patients (50.2%) returned to the ED at some point during our 7-year study period, and 36% of patients had an ED revisit or death within 1 year. In multivariate logistic regression, male sex and comorbidities were associated with ED revisits and death.
  
  
  CONCLUSIONS
  More than one-third of older adult ED fall patients had an ED revisit or died within 1 year. Falls are one of the geriatric syndromes that contribute to frequent ED revisits and death rates. Future research should determine whether falls increase the risk of such outcomes and how to prevent future fall and death.
authors.affiliation: Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA. Electronic address: sliu1@partners.org.
authors.forename: Shan W
authors.initials: SW
authors.lastname: Liu
authors.affiliation: Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA.
authors.forename: Ziad
authors.initials: Z
authors.lastname: Obermeyer
authors.affiliation: General Medicine Division, Massachusetts General Hospital, Boston, MA.
authors.forename: Yuchiao
authors.initials: Y
authors.lastname: Chang
authors.affiliation: Department of Emergency Medicine, Boston University Medical Center, Boston, MA.
authors.forename: Kalpana N
authors.initials: KN
authors.lastname: Shankar
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D015897:Comorbidity; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D016015:Logistic Models; D008297:Male; D009026:Mortality; D015999:Multivariate Analysis; D010359:Patient Readmission / Q000706:statistics & numerical data*; D015995:Prevalence; D012189:Retrospective Studies; D012737:Sex Factors