Cardiovascular disease and the risk of incident falls and mortality among adults aged ≥ 65 years presenting to the emergency department: a cohort study from national registry data in Denmark

Aisling M. O’Halloran*, Jolien Cremers, Karsten Vrangbæk, Lorna Roe, Robert Bourke, Laust H. Mortensen, Rudi G.J. Westendorp, Rose Anne Kenny

*Corresponding author af dette arbejde

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

1 Citationer (Scopus)
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Abstract

Background
Falls cause 58% of injury-related Emergency Department (ED) attendances. Previous research has highlighted the potential role of cardiovascular risk factors for falls. This study investigated the impact of cardiovascular disease (CVD) risk on three-year incident falls, with presentation to the ED, and mortality.

Methods
A matched cohort study design was employed using national registry data from 82,292 adults (33% male) aged ≥ 65 years living in Denmark who attended the ED in 2013. We compared age and gender matched ED attendees presenting with a fall versus another reason. The cohort was followed for three-year incident falls, with presentation to the ED, and mortality. The impact of falls-related CVDs was also examined.

Results
Three-year incident falls was twofold higher among age and gender matched ED attendees aged ≥ 65 years presenting with a fall versus another reason at baseline. A presentation of falls with hip fracture had the highest percentage of incident falls in the 65–74 age group (22%) and the highest percentage mortality in all age groups (27–62%). CVD was not a significant factor in presenting with a fall at the ED, nor did it contribute significantly to the prediction of three-year incident falls. CVD was strongly associated with mortality risk among the ED fall group (RR = 1.81, 95% CI: 1.67–1.97) and showed interactions with both age and fall history.

Conclusion
In this large study of adults aged ≥ 65 years attending the ED utilising data from national administrative registers in Denmark, we confirm that older adults attending the ED with a fall, including those with hip fracture, were at greatest risk for future falls. While CVD did not predict incident falls, it increased the risk of mortality in the three-year follow up with advancing age. This may be informative for the provision of care pathways for older adults attending the ED due to a fall.
OriginalsprogEngelsk
Artikelnummer93
TidsskriftBMC Geriatrics
Vol/bind24
Udgave nummer1
Antal sider11
ISSN1471-2318
DOI
StatusUdgivet - 2024

Bibliografisk note

Funding Information:
This work was supported by the European Institute of Innovation & Technology (EIT) Health Frailty and Falls Implantable System for Prediction and Prevention—FFallS Predictor (grant number 19131; 20688) to [RAK] and the Novo Nordisk Fonden Challenge Programme: Harnessing the Power of Big Data to Address the Societal Challenge of Aging (grant number NNF17OC0027812) to [RGJW]. The funders of this study did not play any role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the article for publication. All authors confirm their independence from funders and had full access to all of the data (including statistical reports and tables) in the study and can take responsibility for the integrity of the data and the accuracy of the data analysis.

Publisher Copyright:
© 2024, The Author(s).

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