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Older falleRs : From Emergency to Geriatric Network (OREGoN)

2018年3月28日 更新者:University Hospital, Angers

Analyse de la Prise en Charge et de l'Orientation Des Patients de 75 Ans et Plus Consultant Pour Chute Aux Urgences du CHU Angers : données de l'évaluation Initiale et du Recueil de données effectué un an après Leur Passage Aux Urgences

The fall is a complex process associated with high morbidity and mortality, with an institutionalization rate of up to 40% and a major socio-economic impact.

The prevalence of falls increases with age. In fact, it is estimated that one-third of people over 65 and 50% of those over 80 living at home fall at least once a year, half of whom fall repeatedly.

For all these reasons, the fall is a frequent reason for emergency consultation, and is an integral part of geriatric syndromes at risk of early readmission.

The care of the elderly patient has been the subject of good practice recommendations by the Health Authority (HAS) in 2009, with the aim of referring patients to specialized geriatric care. Among these recommendations is the need to look for signs of geriatric severity of falls.

To our knowledge, few studies have investigated the applicability of HAS recommendations with the practice of emergencies; this study is part of a project to improve practices.

- Hypothesis : Due to the fast pace of emergency medicine, the complexity of elderly patients and the inherent limitations of the care system, we hypothesize that few serious fallers are included in the geriatric pathway after admission to the emergency room (ER).

研究概览

地位

完全的

条件

详细说明

From the database of URQUAL software available at the Emergencies of Angers Hospital and the "list of diagnostics for clinical research", inclusion (over a period arbitrarily defined from October 1, 2015 to November 1, 2015) of patients aged 75 and over with a diagnosis of fall or a related reason when they are admitted to the Emergencies Room.

During the initial consultation in the Emergency Department, documentary analysis with all the signs of seriousness of the falls stated in the report, as defined by HAS 2009:

  • consequences of the fall (moderate to severe physical trauma, inability to rise from the ground and its consequences, post-fall syndrome)
  • pathologies responsible for the fall
  • repetitive nature of the fall (recent increase in the frequency of falls, association of more than 3 risk factors for falls, gait disorders)
  • situations at risk of severe falls (proven osteoporosis, use of anticoagulant drugs, social and family isolation) Search for an anterior passage of the patient in the geriatric pathway.

Collection of the patient's care pathway following this passage to the ER:

  • request for consultation or specialized geriatric care
  • return home / hospitalization / Subacute care and rehabilitation

Data collected one year after the emergency department visit, based on the information available in the URQUAL and CROSSWAY databases accessible at Angers Hospital, are:

  • search for passage in the geriatric pathway following the emergency consultation (external geriatric consultation, intervention of the mobile geriatric team, hospitalization in Geriatrics)
  • readmission to the Emergency Department of Angers University Hospital for fall
  • death Telephone call to the general practitioner one year after the initial admission, in order to search for a recurrence of fall.

This call-back makes it possible to collect data from patients readmitted for a fall in another center (clinic, hospital, etc.) or who have fallen again at home without admission to an emergency service with the aim of limiting the information and monitoring biases.

研究类型

观察性的

注册 (实际的)

204

联系人和位置

本节提供了进行研究的人员的详细联系信息,以及有关进行该研究的地点的信息。

学习地点

      • Angers、法国、49933
        • Angers University Hospital

参与标准

研究人员寻找符合特定描述的人,称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。

资格标准

适合学习的年龄

75年 及以上 (年长者)

接受健康志愿者

不适用

有资格学习的性别

全部

取样方法

非概率样本

研究人群

Patients are recruited during their passage to the Emergency Room of the University Hospital of Angers, France

描述

Inclusion Criteria:

  • Age ≥ 75 years
  • Reason for emergency consultation: fall or a related cause (fracture, head trauma, etc.)

Exclusion Criteria:

  • No one

学习计划

本节提供研究计划的详细信息,包括研究的设计方式和研究的衡量标准。

研究是如何设计的?

设计细节

研究衡量的是什么?

主要结果指标

结果测量
措施说明
大体时间
Measure of the proportion of serious fallers included in the geriatric pathway one year after passing the emergencies.
大体时间:1 year
This outcome is assessed by the number of serious faller patients in the geriatric pathway.
1 year

次要结果测量

结果测量
措施说明
大体时间
Measure of proportion of fallers admitted to emergencies.
大体时间:baseline
This outcome is assessed by the number of fallers admitted to emergencies.
baseline
Measure of proportion of serious fallers admitted to emergencies.
大体时间:baseline
This outcome is assessed by the number of serious fallers admitted to emergencies.
baseline
Number of severity criteria most commonly encountered in emergencies.
大体时间:baseline
This outcome is assessed by the emergencies data.
baseline
Measure of the proportion of patients who fell again within one year of admission to ER.
大体时间:1 year
This outcome is assessed by the number of patients who fell again within one year of admission to ER.
1 year
Measure of the proportion of patients included in the geriatric pathway readmitted for fall to the ER in the following year.
大体时间:1 year
This outcome is assessed by the number of patients included in the geriatric pathway readmitted for fall to the ER.
1 year

合作者和调查者

在这里您可以找到参与这项研究的人员和组织。

研究记录日期

这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查,以确保它们在发布到公共网站之前符合特定的质量控制标准。

研究主要日期

学习开始 (实际的)

2015年10月1日

初级完成 (实际的)

2017年12月1日

研究完成 (实际的)

2017年12月1日

研究注册日期

首次提交

2018年1月26日

首先提交符合 QC 标准的

2018年3月28日

首次发布 (实际的)

2018年4月5日

研究记录更新

最后更新发布 (实际的)

2018年4月5日

上次提交的符合 QC 标准的更新

2018年3月28日

最后验证

2018年1月1日

更多信息

与本研究相关的术语

其他研究编号

  • 2017-05

药物和器械信息、研究文件

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此信息直接从 clinicaltrials.gov 网站检索,没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求,请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改,我们的网站上也会自动更新.

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