Background Falls in elderly people are a common presenting complaint to accident and emergency departments.
Current practice commonly focuses on the injury, with little systematic assessment of the underlying cause, functional consequences, and possibilities for future prevention.
We undertook a randomised controlled study to assess the benefit of a structured inderdisciplinary assessment of people who have fallen in terms of further falls.
Methods Eligible patients were aged 65 years and older, lived in the community, and presented to an accident and emergency department with a fall.
Patients assigned to the intervention group (n=184) underwent a detailed medical and occupational-therapy assessment with referral to relevant services if indicated ; those assigned to the control group (n=213) received usual care only.
The analyses were by intention to treat.
Follow-up data were collected every 4 months for 1 year.
Findings At 12-month follow-up, 77% of both groups remained in the study.
The total reported number of falls during this period was 183 in the intervention group compared with 510 in the control group (p=0.0002).
The risk of falling was significantly reduced in the intervention group (odds ratio 0.39 [95% Cl 0.23-0.66]) as was the risk of recurrent falls (0.33 [0.16-0.68]). In addition, the odds of admission to hospital were lower in the intervention group (0.61 [0.35-1.05]) whereas the decline in Barthel score with time was greater in the control group (p<0. (...)
Mots-clés Pascal : Royaume Uni, Europe, Personne âgée, Homme, Chute, Traumatisme, Prévention, Randomisation, Etude comparative, Etude longitudinale, Etude statistique, Analyse coût
Mots-clés Pascal anglais : United Kingdom, Europe, Elderly, Human, Fall, Trauma, Prevention, Randomization, Comparative study, Follow up study, Statistical study, Cost analysis
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0093556
Code Inist : 002B30A03B. Création : 31/05/1999.