Four in ten older adults revisit the ED within a year of a fall presentation

Design

Systematic review and meta-analysis of 19 observational studies

Population

Adults aged ≥65 presenting to the ED after a fall

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

A meta-analysis of 19 observational studies followed adults aged 65 or over after an emergency department visit for a fall. Risk of bias was low to moderate.

Cumulative ED revisits were 3.9% at 3 days, 8.8% at 7 days, 15.0% at 30 days, 37.5% at 6 months and 41.3% at 12 months. Hospital readmissions were 10.4% at 30 days and about 30% by 6 to 12 months (later estimates from single studies). Heterogeneity was substantial.

A fall presentation marks a vulnerable patient, not a one-off event. The first month carries 15% revisit risk, which is the window for a falls assessment, medication review and follow-up. Whether targeted follow-up prevents revisits has not yet been tested.

• Arrange follow-up within two weeks of any ED fall presentation.
• Send a discharge summary asking the GP to complete a falls and medication review.
• Refer for strength and balance training where mobility allows.
• Flag patients with a second fall visit for comprehensive geriatric assessment.

Why it matters

Most EDs discharge a non-injured faller without a plan, yet four in ten return within a year.

Don't overread it

The studies describe risk; none tested whether follow-up reduces revisits.

The statistics, in plain English

These are cumulative proportions: 41% had at least one revisit by 12 months. Substantial heterogeneity means different health systems had quite different rates, so local figures may differ.

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