Table 2.
The conditions/associated factors of fall and the key evaluation elements among mechanical and nonmechanical older adult ED fall patients
| Mechanical, n = 218 (%) |
Nonmechanical, n = 132 (%) |
P | |
|---|---|---|---|
| Conditions/associated factors of fall | |||
| Environment | 125 (57.3) | 38 (28.8) | <.01 |
| Poor light source | 7 (3.2) | 0 | .05 |
| Uneven or slippery surfaces | 77 (35.3) | 22 (16.7) | <.01 |
| Loose rugs | 13 (6.0) | 2 (1.5) | .06 |
| Steep stairs | 10 (4.6) | 3 (2.3) | .39 |
| Objects in pathway | 12 (5.5) | 7 (5.3) | .94 |
| Lack of handrails | 4 (1.8) | 1 (0.8) | .65 |
| Inappropriate furniture | 5 (2.3) | 2 (1.5) | .72 |
| Aging/functional decline | 59 (27.0) | 44 (33.3) | .21 |
| Weakness | 12 (5.5) | 14 (10.6) | .08 |
| Poor balance | 48 (22.2) | 33 (25.0) | .52 |
| Vision impairment | 2 (0.9) | 0 | .53 |
| Syncope and presyncope | 2 (0.9) | 17 (12.9) | <.01 |
| Other medical problems | 4 (1.8) | 9 (6.8) | .02 |
| Delirium | 3 (1.4) | 6 (4.6) | .09 |
| Foot and footwear problem | 4 (1.8) | 1 (0.8) | .65 |
| Unclear | 38 (17.4) | 39 (29.6) | <.01 |
| History key elements | |||
| Indoor | 118 (54.1) | 93 (70.4) | .01 |
| Outdoor | 50 (22.9) | 21 (15.9) | .01 |
| Not recorded | 50 (22.9) | 18 (13.6) | .03 |
| Fall history asked about | 60 (27.5) | 57 (43.2) | <.01 |
| Loss of consciousness/Altered mental status | 10 (4.6) | 33 (25.0) | <.01 |
| Alcohol use | 42 (19.3) | 26 (19.7) | .92 |
| Polypharmacy (≥5 medications), n (%) | 151 (71.6) | 95 (71.9) | .93 |
| Independence with ADLs | 90/115 (78.3) | 47/73 (64.4) | .04 |
| Dementia | 21 (9.6) | 25 (18.9) | .01 |
| Prior hip fracture | 18 (8.2) | 7 (5.3) | .29 |
| Physical examination key elements | |||
| Gait and/or balance evaluation | 35 (16.1) | 25 (18.9) | .49 |
| Orthostatic evaluation | 22 (10.1) | 21 (15.9) | .11 |
| Cognitive assessment (orientation to time, place, person) | 216 (99.1) | 130 (99.5) | .61 |
| Muscle strength test | 132 (60.5) | 67 (50.8) | .07 |
| Foot problem evaluation | 3 (1.4) | 2 (1.5) | .08 |
| Investigation evaluation | |||
| Complete blood count | 116 (53.2) | 83 (62.9) | .07 |
| Electrolyte panel | 116 (53.2) | 83 (62.9) | .07 |
| ECG, n = 127 | 69 (31.6) | 58 (43.9) | .02 |
| New ECG abnormalities, n = 11 | 8 (11.6) | 3 (5.2) | .23 |
| Atrial fibrillation | 5 (7.2) | 1 (1.7) | .24 |
| Sinus bradycardia | 2 (2.9) | 1 (1.7) | 1.00 |
| ST abnormality | 1 (1.5) | 1 (1.7) | 1.00 |
| X-ray, n = 275 | 178 (81.7) | 97 (73.5) | .07 |
| CT, n = 184 | 104 (47.7) | 80 (60.6) | .02 |
| CT abnormality, n = 67 | 42 (40.4) | 25 (31.3) | .20 |
| Head CT abnormality, n = 56 | 33 (31.7) | 23 (28.8) | .66 |
| Soft tissue injury | 17 (16.4) | 8 (10.0) | .21 |
| Fracture | 10 (9.6) | 5 (6.3) | .41 |
| Subarachnoid hemorrhage | 1 (1.0) | 5 (6.3) | .09 |
| Subdural hematoma | 1 (1.0) | 4 (5.0) | .17 |
| Cerebral hemorrhage | 1 (1.0) | 0 | 1.00 |
| Cerebral contusion | 1 (1.0) | 0 | 1.00 |
| Safety assessment before ED disposition | |||
| Get-up and go test | 8 (3.7) | 0 | .08 |
| Patients have PT evaluation | 26 (11.9) | 20 (15.2) | .39 |
Abbreviation: ADLs, activities of daily living.