Falls Validation Study
Ориентир для пациента и семьи
Простыми словами
Автоматическая сводка по структурированным данным реестра. Она помогает сориентироваться, но не заменяет официальный протокол или оценку врача.
- Что изучают
- В протоколе указаны: Clinical Decision Rule.
- Кому может быть актуально
- Состояния в реестре: Intracranial Bleed, Falls. Базовые параметры: от 65 лет · Все.
- Что важно проверить
- Возраст, диагноз и пол — только базовые ориентиры. Предыдущее лечение, анализы и другие обязательные условия указаны ниже в критериях участия.
- Где проводится
- США, Канада
- Следующий шаг
- Сохраните исследование, покажите его лечащему врачу и уточните актуальный статус у исследовательского центра. Расходы, документы и поездка →
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Официальное название
Validation of the Falls Decision Rule for Diagnosing Intracranial Bleeding in Older Adults After a Fall
Обзор
Each year, one in three adults over the age of 65 has a fall. These falls lead to half a million Canadian emergency department patient visits annually and falls in older adults account for more than 3% of all emergency department visits. A rapid, simple bedside test (known as a decision rule) to guide emergency physicians on when older adults should have a brain scan to diagnose traumatic brain bleeding was created. This decision rule will be checked to see if it works well in guiding who needs a brain scan.
Подробное описание
Traumatic intracranial bleeding is much more prevalent in older adults and has a much worse prognosis as compared to the younger population. Older adults are at risk of traumatic intracranial bleeding because there is loss of the elastic integrity of the cerebral bridging veins and brain atrophy, allowing rapid movements of the brain with trauma. The vast majority of traumatic intracranial bleeding diagnoses in older adults result from low-energy falls from standing or sitting.
In 2015, the Canadian Medical Association called for a national strategy for older adults that would include evidence-based hospital practices. In 2021-22, older adults accounted for about 25% of all Canadian emergency department visits, and older adults who had fallen account for over 3% of visits. This number continues to rise. A conservative estimation using 2022 Canadian Institute of Health Information data suggests there are at least 500,000 emergency department visits from older adults after a fall annually in Canada, yet there is little research evidence to guide testing for intracranial bleeding.
It is difficult for physicians to determine the risk of intracranial bleeding when an older patient has fallen. Diagnosing fall-related intracranial bleeding is an important part of the emergency department assessment. It is critical that older patients with intracranial bleeding are identified early so that they are provided with appropriate medical and neurosurgical care
To address the lack of evidence-based guidance specific to older adults who fall, the Falls Decision Rule was derived to guide the use of brain imaging.
Validation of the Falls Rules would improve image utilization for older adults who have fallen, meaning that intracranial bleeding would be diagnosed on the first emergency department visit. People with very low risk of intracranial bleeding would not need brain imaging which facilitates a faster discharge from the emergency department.
Вмешательства
- Другое Clinical Decision Rule
The Falls Decision Rule will help guide emergency physicians when to obtain brain imaging and when brain imaging is not required.
Первичные конечные точки
- Clinically Important Intracranial Bleeding [Срок оценки: 30 days]
Вторичные конечные точки (4)
- Clinically Unimportant Intracranial Bleeding [Срок оценки: 30 days]
- Delayed Intracranial Bleeding [Срок оценки: 30 days]
- Death [Срок оценки: 120 days]
- Recurrent Falls [Срок оценки: 120 days]
Критерии участия
Критерии включения
- Age 65 or older
- Present to the emergency department within 48 hours of having a fall
- Fall from standing, from a chair, toilet seat, or bed
Критерии исключения
- Transferred from another hospital organization after brain imaging
- Leave the emergency department prior to completion of their medical assessment
- Previously enrolled
- Lives outside the hospital catchment area
Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.
Здоровые добровольцы: Нет
Дизайн исследования
- Модель наблюдения
- Когортное
Центры проведения
Канада · 6 центров
- Hamilton Health Sciences Corporation — Hamilton
- Kingston Health Sciences Centre — Kingston
- Ottawa Hospital Research Institute — Ottawa
- Sinai Health System — Toronto
- Centre Intégré Universitaire De Santé Et De Services Sociaux Du Nord-De-L'île-De-Montréal, — Montreal
- CHU de Québec - Université Laval — Québec
США · 1 центр
- Massachusetts General Hospital — Boston
Идентификаторы
NCT: NCT07536906 · 202409PJT · 527093-202409PJT