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When falls become fatal—Clinical care sequence

OBJECTIVES: This study encompassed fall-related deaths, including those who died prior to medical care, that were admitted to multiple healthcare institutions, regardless of whether they died at home, in long-term care, or in hospice. The common element was that all deaths resulted directly or indir...

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Autores principales: Drake, Stacy A., Conway, Sadie H., Yang, Yijiong, Cheatham, Latarsha S., Wolf, Dwayne A., Adams, Sasha D., Wade, Charles E., Holcomb, John B.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7787527/
https://www.ncbi.nlm.nih.gov/pubmed/33406164
http://dx.doi.org/10.1371/journal.pone.0244862
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author Drake, Stacy A.
Conway, Sadie H.
Yang, Yijiong
Cheatham, Latarsha S.
Wolf, Dwayne A.
Adams, Sasha D.
Wade, Charles E.
Holcomb, John B.
author_facet Drake, Stacy A.
Conway, Sadie H.
Yang, Yijiong
Cheatham, Latarsha S.
Wolf, Dwayne A.
Adams, Sasha D.
Wade, Charles E.
Holcomb, John B.
author_sort Drake, Stacy A.
collection PubMed
description OBJECTIVES: This study encompassed fall-related deaths, including those who died prior to medical care, that were admitted to multiple healthcare institutions, regardless of whether they died at home, in long-term care, or in hospice. The common element was that all deaths resulted directly or indirectly from injuries sustained during a fall, regardless of the temporal relationship. This comprehensive approach provides an unusual illustration of the clinical sequence of fall–related deaths. Understanding this pathway lays the groundwork for identification of gaps in healthcare needs. DESIGN: This is a retrospective study of 2014 fall-related deaths recorded by one medical examiner’s office (n = 511) within a larger dataset of all trauma related deaths (n = 1848). Decedent demographic characteristics and fall-related variables associated with the deaths were coded and described. RESULTS: Of those falling, 483 (94.5%) were from heights less than 10 feet and 394 (77.1%) were aged 65+. The largest proportion of deaths (n = 267, 52.3%) occurred post-discharge from an acute care setting. Of those who had a documented prior fall, 216 (42.3%) had a history of one fall while 31 (6.1%) had ≥2 falls prior to their fatal incident. For the 267 post-acute care deaths, 440 healthcare admissions were involved in their care. Of 267 deaths occurring post-acute care, 129 (48.3%) were readmitted within 30 days. Preventability, defined as opportunities for improvement in care that may have influenced the outcome, was assessed. Of the 1848 trauma deaths, 511 (27.7%) were due to falls of which 361 (70.6%) were determined to be preventable or potentially preventable. CONCLUSION: Our data show that readmissions and repeated falls are frequent events in the clinical sequence of fall fatalities. Efforts to prevent fall-related readmissions should be a top priority for improving fall outcomes and increasing the quality of life among those at risk of falling.
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spelling pubmed-77875272021-01-14 When falls become fatal—Clinical care sequence Drake, Stacy A. Conway, Sadie H. Yang, Yijiong Cheatham, Latarsha S. Wolf, Dwayne A. Adams, Sasha D. Wade, Charles E. Holcomb, John B. PLoS One Research Article OBJECTIVES: This study encompassed fall-related deaths, including those who died prior to medical care, that were admitted to multiple healthcare institutions, regardless of whether they died at home, in long-term care, or in hospice. The common element was that all deaths resulted directly or indirectly from injuries sustained during a fall, regardless of the temporal relationship. This comprehensive approach provides an unusual illustration of the clinical sequence of fall–related deaths. Understanding this pathway lays the groundwork for identification of gaps in healthcare needs. DESIGN: This is a retrospective study of 2014 fall-related deaths recorded by one medical examiner’s office (n = 511) within a larger dataset of all trauma related deaths (n = 1848). Decedent demographic characteristics and fall-related variables associated with the deaths were coded and described. RESULTS: Of those falling, 483 (94.5%) were from heights less than 10 feet and 394 (77.1%) were aged 65+. The largest proportion of deaths (n = 267, 52.3%) occurred post-discharge from an acute care setting. Of those who had a documented prior fall, 216 (42.3%) had a history of one fall while 31 (6.1%) had ≥2 falls prior to their fatal incident. For the 267 post-acute care deaths, 440 healthcare admissions were involved in their care. Of 267 deaths occurring post-acute care, 129 (48.3%) were readmitted within 30 days. Preventability, defined as opportunities for improvement in care that may have influenced the outcome, was assessed. Of the 1848 trauma deaths, 511 (27.7%) were due to falls of which 361 (70.6%) were determined to be preventable or potentially preventable. CONCLUSION: Our data show that readmissions and repeated falls are frequent events in the clinical sequence of fall fatalities. Efforts to prevent fall-related readmissions should be a top priority for improving fall outcomes and increasing the quality of life among those at risk of falling. Public Library of Science 2021-01-06 /pmc/articles/PMC7787527/ /pubmed/33406164 http://dx.doi.org/10.1371/journal.pone.0244862 Text en © 2021 Drake et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Drake, Stacy A.
Conway, Sadie H.
Yang, Yijiong
Cheatham, Latarsha S.
Wolf, Dwayne A.
Adams, Sasha D.
Wade, Charles E.
Holcomb, John B.
When falls become fatal—Clinical care sequence
title When falls become fatal—Clinical care sequence
title_full When falls become fatal—Clinical care sequence
title_fullStr When falls become fatal—Clinical care sequence
title_full_unstemmed When falls become fatal—Clinical care sequence
title_short When falls become fatal—Clinical care sequence
title_sort when falls become fatal—clinical care sequence
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7787527/
https://www.ncbi.nlm.nih.gov/pubmed/33406164
http://dx.doi.org/10.1371/journal.pone.0244862
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