TY  - JOUR
PY  - 1990//
TI  - The value of assessing falls in an elderly population. A randomized clinical trial
JO  - Annals of internal medicine
A1  - Rubenstein, Laurence Z.
A1  - Robbins, A. S.
A1  - Josephson, Karen R.
A1  - Schulman, B. L.
A1  - Osterweil, D.
SP  - 308
EP  - 316
VL  - 113
IS  - 4
N2  - OBJECTIVE: To measure the effects of a specialized postfall assessment intended to detect causes and underlying risk factors for falls, and to recommend preventive and therapeutic interventions. DESIGN: Randomized, controlled trial. SETTING: A long-term residential care facility for elderly persons. SUBJECTS: Within 7 days of a fall, 160 ambulatory subjects (mean age, 87 years) were randomly assigned to receive either a comprehensive postfall assessment (intervention group, n = 79) or usual care (control group, n = 81). INTERVENTION: The postfall assessment included a detailed physical examination and environmental assessment by a nurse practitioner; laboratory tests; electrocardiogram; and 24-hour Holter monitoring. Probable cause or causes for the fall, identified risk factors, and therapeutic recommendations were given to the patient's primary physician. MEASUREMENTS AND MAIN RESULTS: Through use of the assessment, many remediable problems (for example, weakness, environmental hazards, orthostatic hypotension, drug side effects, gait dysfunction) were detected. At the end of the 2-year follow-up period, the intervention group had 26% fewer hospitalizations (P less than 0.05) and a 52% reduction in hospital days (P less than 0.01) compared with controls. Patients in the intervention group had 9% fewer falls and 17% fewer deaths than controls by 2 years, but these trends were not statistically significant. CONCLUSIONS: Our study suggests that falls are a marker of underlying disorders easily identifiable by a careful postfall assessment, which in turn can reduce disability and costs.<p />  <p>Language: en</p>
LA  - en
SN  - 0003-4819
UR  - http://dx.doi.org/
ID  - ref1
ER  -