doctor Find a doctor

One Fall Too Many

December 31, 1969

For More Information, Contact:
Tim Viall
Office of Communications
[email protected]

One Fall Too Many

Emergency Department Visits Not a Catalyst for Falls Prevention Activities

(Boston) - Aug. 8, 2017 - Adults age 65 and older who go to the emergency department (ED) for a fall-related injury are not likely to participate in a fall prevention program after being discharged, despite being given a flyer for a local program before leaving the hospital. The study highlights the challenges of effectively helping these patients prevent future falls, as well as the importance of educating both patients and providers about available programs geared to help prevent falls in the future.

Each year, a third of those age 65 and older suffer from a fall, and among this age group, falls are the leading cause of fatal and non-fatal injuries, according to the Centers for Disease Control and Prevention. In 2015, 2.5 million older adults went to the ED because of falls and more than 734,000 of those patients were hospitalized. In that year, the direct medical costs related to the falls are estimated to be between $31.3 and $36.8 billion, both adjusted for inflation.

Out of 87 patients enrolled in the study who were interviewed 60 days after their initial ED visit, none reported engaging in fall prevention activities. In addition, fourteen percent of the participants fell again after they were discharged; seven sought medical attention for a subsequent fall and returned to an ED for treatment; and five returned to the ED where they were treated for their first fall.

“For older adults that fall, that first emergency department visit is an important, but underutilized opportunity to mobilize healthcare resources for people at a high risk for subsequent falls,” said Kalpana Narayan Shankar, MD, an emergency medicine physician at Boston Medical Center (BMC) and the study’s corresponding author.

While patients did not enroll in a program, particularly the evidence-based Matter of Balance program detailed on the flyer, many reported discussing their falls with others before the study’s follow up call two months later. Seventy-one percent of patients spoke with a healthcare provider about their fall, 37 percent talked to those providers specifically about ways to reduce falls, and 46 and 36 percent talked to family members or friends, respectively, about what they can do to prevent falls.

“The amount of dialogue patients reported having about their falls is encouraging, but their fall should trigger a more significant health system response to lessen their risk of future falls. This is difficult to accomplish solely in the emergency department due to time and resource constraints,” said Narayan, who stresses that both providers and patients need more education on the effectiveness of clinical and community fall prevention interventions and activities and that they could be an important part of preventing future falls.

The initial flyer may not have spurred enrollment, but forty-two percent of participants did say that it was somewhat, or very likely, that they would participate in a community-based falls prevention program during the next year. It is unclear whether or not those patients eventually enrolled. These results are published online in the journal Injury Epidemiology.

# # #

Pediatric Thyroid Cancer

Thyroid cancer is the third most common solid tumor malignancy and the most common endocrine malignancy in children. It occurs four times more often in females than males and has similar characteristics as adult thyroid cancer.
< Return to

Nodules, Polyps and Cysts

Vocal cord lesions (physicians call them vocal fold lesions) are a group of noncancerous (benign), abnormal growths within or along the covering of the vocal cord. Vocal cord lesions are one of the most common causes of voice problems and are generally seen in three forms; nodules, polyps, and cysts.

< Return to

Laryngopharyngeal Reflux (LPR)

During gastroesophageal reflux, the contents of the stomach and upper digestive tract may reflux all the way up the esophagus, beyond the upper esophageal sphincter (a ring of muscle at the top of the esophagus), and into the back of the throat and possibly the back of the nasal airway. This is known as laryngopharyngeal reflux (LPR).

< Return to

Gastroesophageal Reflux (GERD)

Gastroesophageal reflux disease, or GERD, occurs when acid from the stomach backs up into the esophagus. Normally, food travels from the mouth, down through the esophagus and into the stomach. A ring of muscle at the bottom of the esophagus, the lower esophageal sphincter (LES), contracts to keep the acidic contents of the stomach from “refluxing” or coming back up into the esophagus. In those who have GERD, the LES does not close properly, allowing acid to move up the esophagus.
< Return to

Common Problems That Can Affect Your Voice

The most common causes of hoarseness and vocal difficulties are Acute Laryngitis, Chronic Laryngitis, Laryngopharyngeal Reflux Disease (LPRD), Voice Misuse and Overuse, Benign Vocal Cord Lesions, Vocal Cord Hemorrhage, Vocal Cord Paralysis and Paresis, Laryngeal Cancer.
< Return to


Symptoms of Sinusitis include facial pressure or pain, nasal discharge that is yellow or green, post-nasal drip, and cough. For the most part, sinusitis symptoms, diagnosis, and treatment are the same for the elderly as other adult age groups. However, there are special considerations for older Americans. 

< Return to

Sinus Pain

The body's nasal and sinus membranes have similar responses to viruses, allergic insults, and common bacterial infections. Membranes become swollen and congested. This congestion causes pain and pressure; mucus production increases during inflammation, resulting in a drippy, runny nose. These secretions may thicken over time, may slow in their drainage, and may predispose to future bacterial infection of the sinuses.

< Return to

Sinus Headaches

Sinus and nasal passages can become inflamed leading to a headache. Headache is one of the key symptoms of patients diagnosed with acute or chronic sinusitis. In addition to a headache, sinusitis patients often complain of pain and pressure around the eyes, across the cheeks and the forehead, achy feeling in the upper teeth, fever and chills, facial swelling, nasal stuffiness and yellow or green discharge.

< Return to

Fungal Sinusitis

When the body's immune system is suppressed, fungi find an opportunity to invade the body and a number of side effects occur. Because these organisms do not require light for food production, they can live in a damp and dark environment. The sinuses, consisting of moist, dark cavities, are a natural home to the invading fungi. When this occurs, fungal sinusitis results.

< Return to Pages