Falls in elderly patients are not treated according to national recommendations.

INTRODUCTION: The aim of this study was to evaluate health professionals' compliance with recommendations from the Danish Health Authority (DHA) concerning falls, to study the prevalence of acute hospital visits due to falls, and to compare characteristics of fall patients in two geographically and socioeconomically different areas of Denmark. METHODS: The study was conducted in the emergency departments (ED) of Slagelse Hospital (SH) and Nykøbing Falster Hospital (NFH), both located in Denmark. Included were individuals > 50 years visiting the EDs from January 1 to March 31, 2014 who reported a fall. Information concerning demographic data and comorbidity in fall patients was retrieved from the medical records of the patients. RESULTS: A total of 2,664 individuals > 50 years visited the EDs during the study period. In all, 1,100 individuals (41.2%) reported a fall. In the NFH 236 (44%) and in the SH 223 (39%) of the fall patients had a fracture (p = 0.049). Patients in the more socioeconomically deprived area covered by the NFH were younger and had higher fracture and heart failure rates. Only 2% of the medical records contained answers to all four questions recommended by the DHA for risk screening in fall patients. The number of medical records containing answers to any of the four questions ranged from 17.5% to 25.8%. CONCLUSIONS: Only few fall patients were screened according to DHA recommendations. ED staff´s adherence to guidelines concerning fall risk assessment is poor. Fall patients in a socioeconomically deprived area were younger and had higher fracture and heart failure incidences. FUNDING: This study received funding from the public Regional Research Foundation, Region Zealand, Denmark. TRIAL REGISTRATION: not relevant.

[Fever of unknown origin in the elderly is a diagnostic challenge]. / Der er diagnostiske udfordringer ved feber af ukendt årsag hos ældre

Elderly individuals often have different causes of fever of unknown origin compared to young persons. While infections dominate in the young, system diseases like temporal arteritis and polymyalgia rheumatica, malignancy and drug fever are common causes in the elderly. The symptoms may be blunted with lack of fever. Co-morbidities may complicate, dominate, and confuse the clinical impression. In the diagnostic work-up it is important to consider other co-morbidities and overall frailty. Patients should be informed and their wishes taken into account in the early phase of planning diagnostic work-up and treatment.