Emergency readmissions following geriatric ground-level falls: How does frailty factor in? “Ground-Level Falls among Frail Patients”

Hamidreza Hosseinpour, Khaled El-Qawaqzeh, Collin Stewart, Malak Nazem Akl, Tanya Anand, Michael Hunter Culbert, Adam Nelson, Sai Krishna Bhogadi, Bellal Joseph

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Background: Ground-level falls (GLFs) in older adults are increasing as life expectancy increases, and more patients are being discharged to skilled nursing facilities (SNFs) for continuity of care. However, GLF patients are not a homogenous cohort, and the role of frailty remains to be assessed. Thus, the aim of this study is to examine the impact of frailty on the in-hospital and 30-day outcomes of GLF patients. Materials and Methods: This is a cohort analysis from the Nationwide Readmissions Database 2017. Geriatric (age ≥65 years) trauma patients presenting following GLFs were identified and grouped based on their frailty status. The associations between frailty and 30-day mortality and emergency readmission were examined by multivariate regression analyses adjusting for patient demographics and injury characteristics. Results: A total of 100,850 geriatric GLF patients were identified (frail: 41% vs. non-frail: 59%). Frail GLF patients were younger (81[74–87] vs. 83[76–89] years; p<0.001) and less severely injured–Injury Severity Score [ISS] (4[1–9] vs. 5[2–9]; p<0.001). Frail patients had a higher index mortality (2.9% vs. 1.9%; p<0.001) and higher 30-day readmissions (14.0% vs. 9.8%; p<0.001). Readmission mortality was also higher in the frail group (15.2% vs. 10.9%; p<0.001), with 75.2% of those patients readmitted from an SNF. On multivariate analysis, frailty was associated with 30-day mortality (OR 1.75; p<0.001) and 30-day readmission (OR 1.49; p<0.001). Conclusion: Frail geriatric patients are at 75% higher odds of mortality and 49% higher odds of readmission following GLFs. Of those readmitted on an emergency basis, more than one in seven patients died, 75% of whom were readmitted from an SNF. This underscores the need for optimization plans that extend to the post-discharge period to reduce readmissions and subsequent high-impact consequences.

Original languageEnglish (US)
Pages (from-to)3723-3728
Number of pages6
JournalInjury
Volume53
Issue number11
DOIs
StatePublished - Nov 2022

Keywords

  • Frailty
  • Ground-level falls
  • Older adults
  • Readmission
  • Trauma

ASJC Scopus subject areas

  • Emergency Medicine
  • Orthopedics and Sports Medicine

Fingerprint

Dive into the research topics of 'Emergency readmissions following geriatric ground-level falls: How does frailty factor in? “Ground-Level Falls among Frail Patients”'. Together they form a unique fingerprint.

Cite this