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CompletedNCT03488615OREGoNUpdated Apr 5, 2018

Older falleRs : From Emergency to Geriatric Network

An observational study in Fall Patients, sponsored by University Hospital, Angers. Completed at 1 site in France. Open to participants aged 75 Years and older. Per ClinicalTrials.gov, last updated 2018-04-05.

Sponsored by University Hospital, Angers · Observational

Study type
Observational
Model
Cohort
Time perspective
Retrospective
Enrollment
204
Ages
75 Years and older
Sex
All
01

Study summary

The fall is a complex process associated with high morbidity and mortality, with an institutionalization rate of up to 40% and a major socio-economic impact.

The prevalence of falls increases with age. In fact, it is estimated that one-third of people over 65 and 50% of those over 80 living at home fall at least once a year, half of whom fall repeatedly.

For all these reasons, the fall is a frequent reason for emergency consultation, and is an integral part of geriatric syndromes at risk of early readmission.

The care of the elderly patient has been the subject of good practice recommendations by the Health Authority (HAS) in 2009, with the aim of referring patients to specialized geriatric care. Among these recommendations is the need to look for signs of geriatric severity of falls.

To our knowledge, few studies have investigated the applicability of HAS recommendations with the practice of emergencies; this study is part of a project to improve practices.

  • Hypothesis : Due to the fast pace of emergency medicine, the complexity of elderly patients and the inherent limitations of the care system, we hypothesize that few serious fallers are included in the geriatric pathway after admission to the emergency room (ER).
Read the detailed description

From the database of URQUAL software available at the Emergencies of Angers Hospital and the "list of diagnostics for clinical research", inclusion (over a period arbitrarily defined from October 1, 2015 to November 1, 2015) of patients aged 75 and over with a diagnosis of fall or a related reason when they are admitted to the Emergencies Room.

During the initial consultation in the Emergency Department, documentary analysis with all the signs of seriousness of the falls stated in the report, as defined by HAS 2009:

  • consequences of the fall (moderate to severe physical trauma, inability to rise from the ground and its consequences, post-fall syndrome)
  • pathologies responsible for the fall
  • repetitive nature of the fall (recent increase in the frequency of falls, association of more than 3 risk factors for falls, gait disorders)
  • situations at risk of severe falls (proven osteoporosis, use of anticoagulant drugs, social and family isolation) Search for an anterior passage of the patient in the geriatric pathway.

Collection of the patient's care pathway following this passage to the ER:

  • request for consultation or specialized geriatric care
  • return home / hospitalization / Subacute care and rehabilitation

Data collected one year after the emergency department visit, based on the information available in the URQUAL and CROSSWAY databases accessible at Angers Hospital, are:

  • search for passage in the geriatric pathway following the emergency consultation (external geriatric consultation, intervention of the mobile geriatric team, hospitalization in Geriatrics)
  • readmission to the Emergency Department of Angers University Hospital for fall
  • death Telephone call to the general practitioner one year after the initial admission, in order to search for a recurrence of fall.

This call-back makes it possible to collect data from patients readmitted for a fall in another center (clinic, hospital, etc.) or who have fallen again at home without admission to an emergency service with the aim of limiting the information and monitoring biases.

02

Conditions studied

  • Fall Patients
03

Who can participate

Ages eligible
75 Years and older
Sexes eligible
All
Sampling method
Non-probability sample

Study population

Patients are recruited during their passage to the Emergency Room of the University Hospital of Angers, France

Inclusion criteria

  • Age ≥ 75 years
  • Reason for emergency consultation: fall or a related cause (fracture, head trauma, etc.)

Exclusion criteria

Exclusion Criteria:

  • No one
04

Study design

Observational model
Cohort
Time perspective
Retrospective
Enrollment
204 participants (actual)
Patient registry
No
05

What researchers measure

Primary outcomes

  1. Measure of the proportion of serious fallers included in the geriatric pathway one year after passing the emergencies.

    This outcome is assessed by the number of serious faller patients in the geriatric pathway.

    Time frame: 1 year

Secondary outcomes

  1. Measure of proportion of fallers admitted to emergencies.

    This outcome is assessed by the number of fallers admitted to emergencies.

    Time frame: baseline

  2. Measure of proportion of serious fallers admitted to emergencies.

    This outcome is assessed by the number of serious fallers admitted to emergencies.

    Time frame: baseline

  3. Number of severity criteria most commonly encountered in emergencies.

    This outcome is assessed by the emergencies data.

    Time frame: baseline

  4. Measure of the proportion of patients who fell again within one year of admission to ER.

    This outcome is assessed by the number of patients who fell again within one year of admission to ER.

    Time frame: 1 year

  5. Measure of the proportion of patients included in the geriatric pathway readmitted for fall to the ER in the following year.

    This outcome is assessed by the number of patients included in the geriatric pathway readmitted for fall to the ER.

    Time frame: 1 year

06

Study locations

1 site
  • Angers University Hospital
    Angers, 49933, France
07

Registry details

Key details

Study ID
NCT03488615
Lead sponsor
University Hospital, Angers
Responsible party
Sponsor
First posted
Apr 5, 2018
Start date
Oct 1, 2015
Primary completion
Dec 1, 2017
Completion
Dec 1, 2017
Last update
Apr 5, 2018

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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