The tale of 1000 fallers aged 65 yrs and over attending the Northumbria Specialist Emergency Care Hospital: 5-year outcome data

Introduction:

This audit was performed by the Northumbria-Healthcare NHS Foundation Trust (NHFCT) Falls and Syncope Service to inform the development of the NHFCT Integrated Falls Strategy (IFS).

Method:

From the opening of the Northumbria Specialist Emergency Care Hospital (NSECH) on 16/06/2015 all ED records were prospectively screened to identify the first 1000 patients aged 65 years and over that had attended with a fall. The 5-year outcome data was obtained from NHFCT electronic records.

Results:

Of the 1000 attends aged 65 years and over with a fall (13.7 attends daily), 55 were patients who reattended having had a further fall. Index characteristics of 945 fallers include: - 64% female, mean age 81.8+/-8.4 years, 79% resided at home, 47% attended with accidental falls, 26% attended with a fracture, 10% with a hip fracture. 5-year outcome data was available for 870 of 945 patients. Of these 870 patients, 28% died within one year and 64% died within 5 years. Men, those who lived in residential or nursing care, those who’s index fall was associated with a hip fracture, those that were admitted to hospital and those who initially presented with unexplained or recurrent falls were more likely to have died at 30 days, one year and 5 years. Of 870 patients, 51% reattended ED with a further fall (mean 2.4 reattends with a fall) and 17% with a subsequent fracture within 5 years. Women, those who lived in sheltered accommodation and those who initially presented with unexplained or recurrent falls were more likely to reattend with a further fall or fracture.

Conclusion:

If the NHFCT IFS aims to reduce further ED attends with a fall and fractures, then this data suggests that the focus should be on those who present with unexplained or recurrent falls and those who live in sheltered accommodation.