- Design
- Systematic review and random-effects meta-analysis of observational studies
- Population
- Adults aged 65+ presenting to the ED after a fall (19 studies)
- Primary outcome
- ED revisits and hospital readmissions within 1 year
- Effect
- ED revisit 15.0% at 30 days, 41.3% at 12 months; readmission 10.4% at 30 days
This systematic review and meta-analysis pooled 19 observational studies of adults aged 65 or older who presented to an emergency department after a fall, estimating repeat attendance and admission over the following year.
Cumulative ED revisits rose from 3.9% within 3 days to 8.8% at 7 days, 15.0% at 30 days, 37.5% at 6 months and 41.3% at 12 months. Hospital readmission was 10.4% at 30 days and 30.4% at 6 months. Heterogeneity was substantial.
A fall that ends with discharge from the ED is often treated as a minor event. These figures show it marks an older person entering a year of repeated acute care, and it is the best opportunity to intervene.
The study does not show which follow-up prevents revisits, but the scale of the problem makes a structured post-fall pathway hard to argue against.
- Treat any fall-related ED attendance in an older adult as a trigger for multifactorial falls assessment.
- Review medications, orthostatic blood pressure, vision, cognition and home hazards.
- Arrange primary care or falls clinic follow-up within days, not months.
- Flag the first week, when revisit rates climb fastest.
Why it matters
A fall seen in the ED is a marker of broader vulnerability, not an isolated accident.
Don't overread it
The studies were observational with high heterogeneity, and some time points came from a single study.
The statistics, in plain English
Cumulative proportions add up over time, so the 41% at 12 months includes those who returned in the first week. Substantial heterogeneity means rates varied between health systems, so local figures may differ.
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