Abstract
Objectives
Falls are an important issue in older adults as they are frequent, deleterious, and
often lead to repeated consultations at the emergency department (ED) and unplanned
hospitalizations. Our principal objective was to provide an inventory of interventions
designed to prevent unplanned readmissions or ED visits of older patients presenting
to hospital with a fall.
Design
Systematic review performed on February 11, 2019 in MEDLINE via PubMed, EMBASE, Cochrane
Central Register of Controlled Trials, and Web of Science, without date or language
restriction. We manually updated this search in August 1, 2019. Study selection, data
extraction and risk of bias assessment were conducted independently by 2 reviewers.
Setting and Participants
We included studies reporting interventions to prevent unplanned readmissions or ED
visits of older patients (aged 65 years or over) presenting to hospital because of
a fall.
Results
We identified 475 unique citations after removing duplicates and included 6 studies
(2 observational and 4 interventional studies). The studies were published between
2012 and 2019; they evaluated heterogeneous interventions that were frequently multifaceted
and multidisciplinary. The interventions were shown effective in reducing readmissions
or ED revisits compared with control groups in 3 studies (relative risk reductions
between 30% and 65%), all of which were multifaceted and 2/3 multidisciplinary.
Conclusions and Implications
With 6 articles showing inconsistent results, our study highlights the need to adequately
design and evaluate interventions to reduce the burden of hospital readmissions among
older fallers. Retrieved studies are recent, which underlines that hospital readmissions
are a current concern for researchers and public health authorities [PROSPERO registration
number: CRD42019131965].
Keywords
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Article info
Publication history
Published online: July 12, 2020
Footnotes
This research did not receive any funding from agencies in the public, commercial, or not-for-profit sectors.
The authors declare no conflicts of interest.
Identification
Copyright
© 2020 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
