title: Serious conditions for ED elderly fall patients: a secondary analysis of the Basel Non-Specific Complaints study.
abstract: OBJECTIVE
  Falls among older adults are a public health problem and are multifactorial. We sought to determine whether falls predict more serious conditions in older adult patients presenting to the emergency department (ED) with a "nonspecific complaint" (NSC). A secondary objective was to examine what factors predicted serious conditions among older adult patients with a fall.
  
  
  METHODS
  This study was a secondary analysis of a prospective delayed-type cross-sectional diagnostic study that included a 30-day follow-up. We included patients 65 years and older who presented to the ED from May 2007 and July 2011 with a NSC and had an Emergency Severity Index score of 2 or 3. We then compared the serious conditions among older adults who presented to the ED with a fall with those who did not fall in a cohort of patients with NSC.
  
  
  RESULTS
  We had 1111 patients enrolled in our study; 518 (47%) of them had fallen. We found that 310 (60%) of elderly fall patients vs 349 (59%) of nonfall patients had a 30-day serious condition (P=.74). In multiple logistic regression analysis, falls did not predict serious conditions or 30-day mortality among all NSC patients. Among fall patients, male sex, diuretic use, and generalized weakness predicted serious conditions.
  
  
  CONCLUSIONS
  Fall patients share many features with nonfall NSC patient. However, falls did not increase the risk of serious conditions. Falls in the elderly could be considered under the broader entity of NSC.
authors.affiliation: Emergency Department, Massachusetts General Hospital, Boston, MA. Electronic address: shanliu635@gmail.com.
authors.forename: Shan W
authors.initials: SW
authors.lastname: Liu
authors.affiliation: Emergency Department, Vajira Hospital, Navamindrahiraj University, Bangkok, Thailand. Electronic address: Jiraporn.rew@gmail.com.
authors.forename: Jiraporn
authors.initials: J
authors.lastname: Sri-On
authors.affiliation: Emergency Department, Massachusetts General Hospital, Boston, MA. Electronic address: gregt89@yahoo.com.
authors.forename: Gregory Philip
authors.initials: GP
authors.lastname: Tirrell
authors.affiliation: Emergency Department, University Hospital Basel, Basel, Switzerland. Electronic address: Christian.nickle@usb.ch.
authors.forename: Christian
authors.initials: C
authors.lastname: Nickel
authors.affiliation: Emergency Department, University Hospital Basel, Basel, Switzerland. Electronic address: Roland.Bingisser@usb.ch.
authors.forename: Roland
authors.initials: R
authors.lastname: Bingisser
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment; D006801:Humans; D015994:Incidence; D008297:Male; D018908:Muscle Weakness / Q000175:diagnosis* / Q000453:epidemiology; D010349:Patient Compliance; D011446:Prospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D013557:Switzerland / Q000453:epidemiology; D013997:Time Factors