Minor Head Trauma Often Sends Older Adults Back to ED After Discharge
October 4th, 2016
COLUMBUS, OH – U.S. emergency departments treat more than 2 million non-fatal falls among older adults each year. A new study looks at how the high rate of return to EDs among those patients could be lowered.
The report published recently in the Journal of the American Geriatrics Society discussed how chart review was used to determine factors associated with and increasing the risk for a return visit to the ED after discharge.
Ohio State University Wexner Medical Center researchers reviewed electronic medical records of 263 adults ages 65 and older who were evaluated and treated in the institution’s Level 1 Trauma Center for a fall within an 18-month study period and discharged.
“We found that more than one-third of older adults with minor head trauma caused by a fall will need to come back to the emergency room within 90 days after discharge,” said lead author Lauren Southerland, MD.
According to the study, 45% of the injuries were fractures and 34% were abrasions, lacerations, or contusions, with no serious injuries identified in 22% of cases. About 5% returned to the ED within 72 hours, 13% returned within 30 days, and 22% returned within three months.
The odds of returning to the ED within 90 days was more than twice as high for patients with head trauma as for those without that type of injury, with an odds ratio of 2.66.
About half of older adults are discharged after the ED evaluation but remain at risk for functional decline and difficulty accessing resources at home, according to study authors, who proposed that ED staff might be the only healthcare contact for those discharged patients. Emergency clinicians might not have the time or training, however, to ensure that all of the patient’s home healthcare needs are met, they added.
“Older adults with falls are a higher risk population that could benefit from early interventions to reduce their need for recurrent emergency care,” Southerland said in an Ohio State press release. “An emergency department visit for a fall should be seen as an opportunity to address unmet patient care needs.”
Study authors conclude, “These individuals should receive close attention from primary care providers. The link between minor head trauma and ED recidivism is a new finding.”