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1. Magnitude, symmetry and attenuation of upper body accelerations during walking in women: The role of age, fall history and walking surface. (Abstract)

Magnitude, symmetry and attenuation of upper body accelerations during walking in women: The role of age, fall history and walking surface. The present experiment examined the role of age and fall history in upper body accelerations when walking on an even and on an uneven surface.An observational cross-sectional study.The magnitude (root mean square [RMS]), symmetry (harmonic ratio) and attenuation (attenuation coefficient) of upper body accelerations were quantified as primary outcomes; gait

2020 Maturitas

2. ED Prevention of Geriatric Falls

ED Prevention of Geriatric Falls Emergency Medicine > Journal Club > Archive > November 2014 Toggle navigation November 2014 ED Prevention of Geriatric Falls Vignette Mrs. C., an 86-year old female, presents to your academic emergency department (ED) via ambulance after an accidental fall at home. She is a recent widower and lives alone, but she reports that she has two adult “children” that live nearby and check on her every day either in-person or by telephone. About 12-hours prior to ED (...) the prognostic study filter using PUBMED Clinical Query and the search term “geriatric fall*” yielding 5 citations, including the systematic review (see ). You obtain the rest of the PICO Question #1 research manuscripts by reviewing the results and the bibliography of the systematic review. For PICO Question #2, you use the therapy study filter on PUBMED Clinical Query and the search term “fall prevention elderly” yielding 71 citations (see ). Articles Article 1: Article 2: Article 3: Article 4: 1st & 2nd

2014 Washington University Emergency Medicine Journal Club

3. Barriers and enablers that influence guideline-based care of geriatric fall patients presenting to the emergency department. (Abstract)

Barriers and enablers that influence guideline-based care of geriatric fall patients presenting to the emergency department. Geriatric patients commonly present to the ED after a fall. Recent evidence suggests that ED physicians are poorly adherent to published ED-specific geriatric fall guidelines. This study applied a theoretical domains framework (TDF) approach to systematically investigate barriers and enablers in the provision of guideline-based care to ED geriatric fall patients.From June (...) it will lead to better outcomes for geriatric fall patients.This study identified important barriers and enablers to provision of guideline-based care in geriatric ED fall patients. Based on these findings, future implementation of guidelines nationally and internationally should focus on improving knowledge and training on guidelines, improving positive reinforcement for guideline-appropriate management, greater allied health support and further research to support guidelines.© Author(s

2019 Emergency Medicine Journal

4. Effectiveness of the "Timed Up and Go" (TUG) and the Chair test as screening tools for geriatric fall risk assessment in the ED. (Abstract)

Effectiveness of the "Timed Up and Go" (TUG) and the Chair test as screening tools for geriatric fall risk assessment in the ED. We sought to evaluate the effectiveness of the "Timed Up and Go" (TUG) and the Chair test as screening tools in the Emergency Department (ED), stratified by sex.This prospective cohort study was conducted at a Level 1 Trauma center. After consent, subjects performed the TUG and the Chair test. Subjects were contacted for phone follow-up and asked to self-report

2018 American Journal of Emergency Medicine

5. Elderly fall risk prediction using static posturography. Full Text available with Trip Pro

Elderly fall risk prediction using static posturography. Maintaining and controlling postural balance is important for activities of daily living, with poor postural balance being predictive of future falls. This study investigated eyes open and eyes closed standing posturography with elderly adults to identify differences and determine appropriate outcome measure cut-off scores for prospective faller, single-faller, multi-faller, and non-faller classifications. 100 older adults (75.5 ± 6.7 (...) fallers (24), prospective all fallers (42), prospective fallers (22 single, 6 multiple), and prospective non-fallers (47). Non-faller RQ AP range and RQ AP RMS differed from prospective all fallers, fallers, and single fallers. Non-faller eyes closed AP velocity, eyes closed VSM velocity, RQ AP velocity, and RQ VSM velocity differed from multi-fallers. RQ calculations were particularly relevant for elderly fall risk assessments. Cut-off scores from Clinical Cut-off Score, ROC curves, and discriminant

2017 PLoS ONE

6. The epidemiology of elderly falls attended by emergency medical services in Victoria, Australia. (Abstract)

The epidemiology of elderly falls attended by emergency medical services in Victoria, Australia. With an increase in the proportion of older people in the community comes an increase in the demand on emergency medical services (EMS) by elderly patients who have fallen.To describe the epidemiology of elderly falls patients attended by EMS in Victoria, Australia and identify predictors of transport and repeat falls.A retrospective review included all elderly (age ≥ 65 years) falls patients (...) attended by EMS between 2010 and 2017. Patient characteristics are described using descriptive statistics. Predictors of transport to hospital and repeat falls were identified using multivariable logistic regression analyses.Between 2010 and 2017 EMS attended 324,060 elderly falls patients, which represents 9.7% of EMS attended workload in Victoria. The median age of patients was 83 years (IQR: 76-88) and 60.2% were female. Comorbidities and medication use were common, while private residence (64.3

2018 Injury

7. Blunt cerebrovascular injury in elderly fall patients: are we screening enough? Full Text available with Trip Pro

Blunt cerebrovascular injury in elderly fall patients: are we screening enough? Blunt cerebrovascular injuries (BCVI) are generally associated with high-energy injury mechanisms. Less is known regarding lower-energy injuries in elderly patients. We sought to determine the incidence of BCVI and characterize current BCVI screening practices and associated complications in elderly ground-level fall patients (EGLF, ≥ 65 years). We hypothesized that BCVI in EGLF patients would be clinically

2018 World journal of emergency surgery : WJES

8. Real-Life/Real-Time Elderly Fall Detection with a Triaxial Accelerometer Full Text available with Trip Pro

Real-Life/Real-Time Elderly Fall Detection with a Triaxial Accelerometer The consequences of a fall on an elderly person can be reduced if the accident is attended by medical personnel within the first hour. Independent elderly people often stay alone for long periods of time, being in more risk if they suffer a fall. The literature offers several approaches for detecting falls with embedded devices or smartphones using a triaxial accelerometer. Most of these approaches have not been tested

2018 Sensors (Basel, Switzerland)

9. History and physical exam predictors of intracranial injury in the elderly fall patient: A prospective multicenter study. (Abstract)

History and physical exam predictors of intracranial injury in the elderly fall patient: A prospective multicenter study. A prior single-center study demonstrated historical and exam features predicting intracranial injury (ICI) in geriatric patients with low-risk falls. We sought to prospectively validate these findings in a multicenter population.This is a prospective observational study of patients ≥65 years presenting after a fall to three EDs. Patients were eligible if they were (...) applied as a decision rule, 273 patients would not have undergone CT scanning, but 7 injuries would have been missed.In low-risk geriatric fall patients, the best predictors of ICI were physical findings of head trauma and history of LOC.Copyright © 2018. Published by Elsevier Inc.

2018 American Journal of Emergency Medicine

10. Geriatric fall-related injuries Full Text available with Trip Pro

Geriatric fall-related injuries Falls are the leading cause of geriatric injury.We aimed to study the anatomical distribution, severity, and outcome of geriatric fall-related injuries in order to give recommendations regarding their prevention.All injured patients with an age ≥ 60 years who were admitted to Al-Ain Hospital or died in the Emergency Department due to falls were prospectively studied over a four year period.We studied 92 patients. Fifty six of them (60.9%) were females. The mean (...) (standard deviation) of age was 72.2 (9.6) years. Seventy three (89%) of all incidents occurred at home. Eighty three patients (90.2%) fell on the same level. The median (range) ISS was 4 (1-16) and the median GCS (range) was 15 (12-15). The lower limb was the most common injured body region (63%). There were no statistical significant differences between males and females regarding age, ISS, and hospital stay (p = 0.85, p = 0.57, and p = 0.35 respectively).The majority of geriatric fall-related

2016 African health sciences

11. Geriatric falls in the context of a hospital fall prevention program: delirium, low body mass index, and other risk factors Full Text available with Trip Pro

Geriatric falls in the context of a hospital fall prevention program: delirium, low body mass index, and other risk factors Inpatient geriatric falls are a frequent complication of hospital care that results in significant morbidity and mortality.Evaluate factors associated with falls in geriatric inpatients after implementation of the fall prevention program.Prospective observational study comprised of 788 consecutive patients aged 79.5±7.6 years ( [Formula: see text] ± standard deviation) (66 (...) : delirium (odds ratio [OR] =7.33; 95% confidence interval [95% CI] =2.76-19.49; P<0.001), history of falls (OR =2.55; 95% CI =1.05-6.19; P=0.039), age (OR =1.14; 95% CI =1.05-1.23; P=0.001), and BMI (OR =0.91; 95% CI =0.83-0.99; P=0.034).Delirium, history of falls, and advanced age seem to be the primary risk factors for geriatric falls in the context of a hospital fall prevention program. Higher BMI appears to be associated with protection against inpatient geriatric falls.

2016 Clinical interventions in aging

12. Application of National Emergency X-Radiography Utilizations Study low-risk cervical spine criteria in high-risk geriatric falls. (Abstract)

injury."This is a retrospective review of geriatric fall patients presenting to a level 1 trauma center and triaged to the trauma bay. We queried our database from 2008 to 2013. Abstractors recorded GCS, deviation from baseline MS, midline neck tenderness, intoxication, focal deficit, signs of trauma, and presence of other injury. Patients were considered at baseline MS if specific documentation was present on the chart, or if their GCS was 15.Six hundred sixty elderly fall patients were trauma (...) Application of National Emergency X-Radiography Utilizations Study low-risk cervical spine criteria in high-risk geriatric falls. We sought to validate National Emergency X-Radiography Utilizations Study low-risk cervical spine (C spine) criteria in a geriatric trauma population. We sought to determine whether patients' own baseline mental status (MS) could substitute for Glasgow Coma Scale (GCS) to meet the criteria "normal alertness." We further sought to refine the definition of "distracting

2015 American Journal of Emergency Medicine

13. Prospective Validation of Modified NEXUS Cervical Spine Injury Criteria in Low-risk Elderly Fall Patients Full Text available with Trip Pro

was to validate a modified NEXUS criteria in a low-risk elderly fall population with two changes: a modified definition for distracting injury and the definition of normal mentation.This is a prospective, observational cohort study of geriatric fall patients who presented to a Level I trauma center and were not triaged to the trauma bay. Providers enrolled non-intoxicated patients at baseline mental status with no lateralizing neurologic deficits. They recorded midline neck tenderness, signs of trauma (...) Prospective Validation of Modified NEXUS Cervical Spine Injury Criteria in Low-risk Elderly Fall Patients The National Emergency X-radiography Utilization Study (NEXUS) criteria are used extensively in emergency departments to rule out C-spine injuries (CSI) in the general population. Although the NEXUS validation set included 2,943 elderly patients, multiple case reports and the Canadian C-Spine Rules question the validity of applying NEXUS to geriatric populations. The objective of this study

2016 Western Journal of Emergency Medicine

14. Serious conditions for ED elderly fall patients: a secondary analysis of the Basel Non-Specific Complaints study. (Abstract)

Serious conditions for ED elderly fall patients: a secondary analysis of the Basel Non-Specific Complaints study. 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.This study (...) 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.Fall patients share many features with nonfall NSC patient. However, falls did not increase the risk of serious conditions. Falls in the elderly could

2016 American Journal of Emergency Medicine

15. Elderly fall patients triaged to the trauma bay: age, injury patterns, and mortality risk. (Abstract)

Elderly fall patients triaged to the trauma bay: age, injury patterns, and mortality risk. Falls in the elderly are a significant cause of morbidity and mortality. We sought to better categorize this patient population and describe factors contributing to their falls.This is a retrospective review of geriatric patients presenting to a level 1 community trauma center. We queried our trauma database for all patients 65 years and older presenting with fall and triaged to the trauma bay from 2008 (...) in very elderly patients (P = 0.06).Prevention measures to limit morbidity and mortality in elderly fall patients should be aimed at the home setting, where most severe injuries occur. Very elderly patients may be at increased risk for intracranial fall-related injuries.Copyright © 2015 Elsevier Inc. All rights reserved.

2015 American Journal of Emergency Medicine

16. Is there a role for neck manipulation in elderly falls prevention? – An overview Full Text available with Trip Pro

Is there a role for neck manipulation in elderly falls prevention? – An overview Many risk factors exist for falls in the elderly. Dizziness is an important risk factor for such falls. Spinal pain has also been identified as a risk factor for these falls. In this overview of the literature, we examine studies, including trials, of neck manipulation for neck pain, unsteadiness and falls risk relevant to the elderly. We also examine two related, but not mutually exclusive, mechanisms through

2015 The Journal of the Canadian Chiropractic Association

17. Strength and Balance Programs for Elderly Falls

Strength and Balance Programs for Elderly Falls Strength and Balance Programs for Elderly Falls – TheNNTTheNNT Strength and Balance Training Programs for Preventing Falls in the Elderly 11 for prevented fall In summary, for at-risk elderly community dwellers who used balance and strength training: Benefits in NNT 91% saw no benefit 9% were helped by preventing a fall over a 1 year period 1 in 11 at-risk elderly were helped (avoid suffering a fall over a one year period) Harms in NNT 0% were

2010 theNNT

18. Characteristics of elderly fall patients with baseline mental status: high-risk features for intracranial injury. (Abstract)

Characteristics of elderly fall patients with baseline mental status: high-risk features for intracranial injury. Falls are a major cause of morbidity in the elderly.We describe the low-acuity elderly fall population and study which historical and clinical features predict traumatic intracranial injuries (ICIs).This is a prospective observational study of patients at least 65 years old presenting with fall to a tertiary care facility. Patients were eligible if they were at baseline mental

2014 American Journal of Emergency Medicine

19. Impaired Systolic Blood Pressure Recovery Directly After Standing Predicts Mortality in Older Falls Clinic Patients. Full Text available with Trip Pro

Impaired Systolic Blood Pressure Recovery Directly After Standing Predicts Mortality in Older Falls Clinic Patients. Normally, standing up causes a blood pressure (BP) drop within 15 seconds, followed by recovery to baseline driven by BP control mechanisms. The prognostic value of this initial BP drop, but also of the recovery hereafter, is unknown. The aim of this study was to examine the prognostic value of these BP characteristics in response to standing.In a retrospective cohort study (...) 60 seconds may be used as an easily available cardiovascular marker for increased mortality risk in older falls clinic patients.

2013 Biological Sciences and Medical Sciences

20. Diastolic blood pressure drop after standing as a clinical sign for increased mortality in older falls clinic patients. (Abstract)

Diastolic blood pressure drop after standing as a clinical sign for increased mortality in older falls clinic patients. Orthostatic hypotension, postprandial hypotension, and carotid sinus hypersensitivity are hypotensive syndromes with high prevalence in older people. However, their pathophysiology and prognostic significance remain largely unknown.In a retrospective cohort study of 313 consecutive patients visiting our falls outpatient clinic, we examined the clustering of orthostatic

2012 Journal of Hypertension

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