ED Visits for Falls Linked to Higher Short-Term Stroke Risk

TOPLINE: Emergency department (ED) visits for falls are linked to a higher short-term risk for ischemic stroke, particularly within 15 days; patients with a preceding fall visit are older, more often women, and have higher rates of vascular comorbidities.

METHODOLOGY:

• Studies have indicated that a fall can be an initial symptom of an acute ischemic stroke.
• Researchers conducted a case-crossover study using the administrative data of 90,592 adult patients hospitalized with acute ischemic stroke taken from the Healthcare Cost and Utilization Project on all hospital admissions and emergency department visits in 10 states from 2016 to 2020.
• Of these patients, 5230 (5.8%) had an ED treat-and-release visit for a fall within 180 days before their stroke.
• ED visits for falls during case periods (0-15, 16-30, 31-90, and 91-180 days before stroke) were compared with those during control periods (equivalent periods one year prior to stroke).

TAKEAWAY: 

• ED treat-and-release visits for a fall were more common 15 days before stroke than in the corresponding control period (odds ratio, 2.69; 95% CI, 2.37-3.05).
• Patients with vs without an ED treat-and-release visit for a fall were older (mean age, 74.7 vs 70.8 years), more often women (61.9% vs 53.4%), and had higher rates of vascular comorbidities.
• The association between ischemic stroke and a preceding ED treat-and-release visit for a fall diminished as the time interval from hospitalization for ischemic stroke increased but remained significant at all time points.

IN PRACTICE:“ED treat-and-release visits for a fall are associated with significantly increased short-term ischemic stroke risk. These visits may be opportunities to improve stroke diagnostic accuracy and treatment in the ED,” the authors wrote.

SOURCE:The study was led by Jed H. Kaiser, BS, Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, New York City, NY. It was published online on July 12, 2024, in Stroke.

LIMITATIONS: 

Study limitations included the case-crossover design and lack of detailed information about diagnostic evaluations and prescribed medications. The inclusion of the beginning of the COVID-19 pandemic period may have altered emergency care-seeking behaviors. 

DISCLOSURES:

This work was supported through a grant from the National Institute of Neurological Disorders and Stroke. Two authors disclosed ties outside this study. Other authors declared no competing interests.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.