ER2 risk levels and their association with incident falls, their recurrence and post-fall fractures in older women: Results of the EPIDOS study.

Abstract

"Emergency Room Evaluation and Recommendations" (ER2) is a validated clinical tool which stratifies the risk of the occurrence of adverse outcomes in three levels (i.e., low, moderate and high) in older people attending emergency departments. This study examines the association of ER2 risk levels with incident falls, their recurrence and post-fall fractures in older community women. 7147 participants of the EPIDémiologie de l'OStéoporose (EPIDOS) study - an observational population-based cohort study - were selected. ER2 low, moderate and high risk levels were determined at baseline. Incident fall outcomes (i.e., one incident fall without fracture, one incident fall with fracture, ≥2 falls without fracture and≥2 falls with fracture) were collected prospectively every 4months over a 4-year follow-up period. The overall incidence of falls was 26.4.%, regardless of their characteristics. ER2 low risk level (hazard ratio (HR) ≤0.80 with P≤0.001) and high risk (HR≥1.26 with P≤0.001) were associated respectively with low and high incident fall outcomes, except for recurrent falls without fracture. ER2 low and high risk levels were associated with incident falls outcomes in EPIDOS participants, suggesting that the ER2 tool may be useful for stratifying the risk of falls in the older population.