Ten‐year mortality in older patients attending the emergency department after a fall

Aim To determine the dependency scores, long‐term mortality and factors associated with mortality in older people presenting to the emergency department ( ED ) with a fall. Methods Information on sociodemographics, dependency using the B arthel index and fall characteristics were collected from consecutive patients attending the ED over a 6‐month period. Barthel score was reassessed at 12 months. Ten‐year mortality data were obtained through the N ational R egistry D epartment. Results A total of 198 participants, with a mean age (standard deviation) of 76.2 years (6.3 years) and 74% women, were recruited. Of these, 70% sustained falls indoors, while 49% of falls occurred between 06.00 to 12.00 hours. Total B arthel scores were significantly lower at 1‐year follow up compared with baseline (median [interquartile range], 20 [2] vs 18 [5], P  < 0.001). Age ≥75 years was significantly associated with mortality at 1, 3, 5 and 10 years ( HR 3.12, 95% CI 1.48–6.56; HR 2.32, 95% CI 1.37–3.92; HR 1.87, 95% CI 1.21–2.88; and HR 2.25, 95% CI 1.60–3.17, respectively). Indoor falls ( HR 2.54, 95% CI 1.07–6.06; HR 2.01, 95% CI 1.10–3.69), hospital admission ( HR 2.16, 95% CI 1.14–4.10; HR 1.84, 95% CI 1.11–3.07) and B arthel ≤18 ( HR 2.99, 95% CI 1.39–6.44; HR 2.47, 95% CI 1.40–4.33) were significantly associated with 1‐year and 3‐year mortality. Hospital admission ( HR 1.94, 95% CI 1.24–3.01; HR 1.53, 95% CI 1.06–2.23) and B arthel ≤18 ( HR 2.27, 95% CI 1.41–3.66; HR 1.85, 95% CI 1.27–2.68) remained significantly associated with increased mortality at 5 and 10 years. Conclusion Functional ability is significantly reduced at 1 year after an initial presentation to the ED with a fall. Mortality is increased at 1 and 3 years in fallers who experienced indoor falls. The excess mortality associated with hospital admission and lower disability scores is persistent at 5 and 10 years. The results of the present study are invaluable in prognostication and healthcare decision‐making for this group of frail older patients. Geriatr Gerontol Int 2016; 16: 111–117.