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{
    "pk": 14409,
    "title": "Risk Factors of Fall-Related Emergency Department Visits by Fall Location of Older Adults in the US",
    "subtitle": null,
    "abstract": "Introduction: \nPrior evidence indicates that predictors of older adult falls vary by indoor-outdoor location of the falls. While a subset of United States’ studies reports this finding using primary data from a single geographic area, other secondary analyses of falls across the country do not distinguish between the two fall locations. Consequently, evidence at the national level on risk factors specific to indoor vs outdoor falls is lacking.\nMethods:\n Using the 2017 Nationwide Emergency Department Sample (NEDS) data, we conducted a multivariable analysis of fall-related emergency department (ED) visits disaggregated by indoor vs outdoor fall locations of adults 65 years and older (N = 6,720,937) in the US. \nResults:\n Results are compatible with findings from previous primary studies. While women (relative risk [RR] = 1.43, 95% confidence interval [CI], 1.42-1.44) were more likely to report indoor falls, men were more likely to present with an outdoor fall. Visits for indoor falls were highest among those 85 years and older (RR = 2.35, 95% CI, 2.33-2.37) with outdoor fall visits highest among those 84 years and younger. Additionally, the probabilities associated with an indoor fall in the presence of chronic conditions were consistently much higher when compared to an outdoor fall. We also found that residence in metropolitan areas increased the likelihood of an indoor elderly fall compared to higher outdoor fall visits from seniors in non-core rural areas, but both indoor and outdoor fall visits were higher among older adults in higher income ZIP codes.\nConclusion:\n Our findings highlight the contrasting risk profile for elderly ED patients who report indoor vs outdoor falls when compared to the elderly reporting no falls. In conjunction, we highlight implications from three perspectives: a population health standpoint for EDs working with their primary care and community care colleagues; an ED administrative vantage point; and from an individual emergency clinician’s point of view.",
    "language": "en",
    "license": {
        "name": "Creative Commons Attribution 4.0",
        "short_name": "CC BY 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by/4.0"
    },
    "keywords": [
        {
            "word": "Geriatric, EDs, Falls, Indoor, Outdoor, Fall injuries, Falls Prevention, Falls Assessment"
        }
    ],
    "section": "Geriatrics",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/6m14j2j0",
    "frozenauthors": [
        {
            "first_name": "Uma",
            "middle_name": "",
            "last_name": "Kelekar",
            "name_suffix": "",
            "institution": "Marymount University, College of Business, Innovation, Leadership and Technology, Division of Health Care Management, Arlington, Virginia",
            "department": "None"
        },
        {
            "first_name": "Debasree",
            "middle_name": "",
            "last_name": "Das Gupta",
            "name_suffix": "",
            "institution": "Utah State University, Department of Kinesiology and Health Science, Logan, Utah",
            "department": "None"
        },
        {
            "first_name": "Jewel",
            "middle_name": "Goodman",
            "last_name": "Shepherd",
            "name_suffix": "",
            "institution": "University of South Dakota, Beacom School of Business, Vermillion, South Dakota",
            "department": "None"
        },
        {
            "first_name": "Anupam",
            "middle_name": "S.",
            "last_name": "Sule",
            "name_suffix": "",
            "institution": "St. Joseph Mercy Oakland, Department of Informatics and Outcomes, Pontiac, Michigan",
            "department": "None"
        }
    ],
    "date_submitted": "2020-07-29T17:13:15Z",
    "date_accepted": "2020-07-29T17:13:15Z",
    "date_published": "2021-07-19T23:29:11Z",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/14409/galley/7395/download/"
        }
    ]
}