{"id":702,"date":"2025-07-16T09:34:03","date_gmt":"2025-07-16T06:34:03","guid":{"rendered":"https:\/\/tatd.org.tr\/geriatri\/?p=702"},"modified":"2025-07-16T09:34:04","modified_gmt":"2025-07-16T06:34:04","slug":"yaslilarda-dusme-yaklasim-ve-onlemler","status":"publish","type":"post","link":"https:\/\/tatd.org.tr\/geriatri\/genel\/yaslilarda-dusme-yaklasim-ve-onlemler\/","title":{"rendered":"Ya\u015fl\u0131larda D\u00fc\u015fme: Yakla\u015f\u0131m ve \u00d6nlemler"},"content":{"rendered":"\n<p><strong>I. Ya\u015fl\u0131larda D\u00fc\u015fme: Tan\u0131m ve Epidemiyoloji<\/strong><\/p>\n\n\n\n<p>D\u00fc\u015fme, D\u00fcnya Sa\u011fl\u0131k \u00d6rg\u00fct\u00fc taraf\u0131ndan bir ki\u015finin istemsiz olarak yere veya daha d\u00fc\u015f\u00fck bir seviyeye inmesi olarak tan\u0131mlan\u0131r (1). 65 ya\u015f \u00fczeri bireylerin acil servis ba\u015fvurular\u0131 aras\u0131nda en s\u0131k g\u00f6r\u00fclen nedenlerdendir. Ya\u015fl\u0131 hastalar\u0131n %30&#8217;u y\u0131lda en az bir kez d\u00fc\u015ferken, 80 ya\u015f \u00fczeri bireylerde bu oran %50\u2019ye kadar \u00e7\u0131kmaktad\u0131r.&nbsp;Bu vakalar\u0131n yakla\u015f\u0131k yar\u0131s\u0131nda tekrarlayan d\u00fc\u015fmeler g\u00f6r\u00fclmektedir&nbsp;(2).&nbsp;Bak\u0131mevlerinde ya\u015fayan ya\u015fl\u0131 bireylerde ise bu oran %60\u2019a yakla\u015fmaktad\u0131r (3). Ya\u015fl\u0131 bireylerde t\u00fcm acil servis ba\u015fvurular\u0131n\u0131n %10&#8217;unun d\u00fc\u015fmelerle ilgili oldu\u011fu bildirilmektedir. Y\u0131lda \u00fc\u00e7 milyon ya\u015fl\u0131 insan d\u00fc\u015fmeler nedeniyle acil serviste tedavi edilmekte ve 800 binden fazlas\u0131 hastaneye yat\u0131r\u0131lmaktad\u0131r (2,3).&nbsp;&nbsp;Yaralanma bulgusu olmayan d\u00fc\u015fme olgular\u0131nda bile anlaml\u0131 morbidite geli\u015fti\u011fi ve bu durumun fonksiyonel kayb\u0131n ba\u015flang\u0131c\u0131 olabilece\u011fi bildirilmi\u015ftir (4,5). Tekrarlayan d\u00fc\u015fmeler ayr\u0131ca hastalarda korkuya neden olarak, pasifli\u011fi, azalan g\u00fcc\u00fc ve azalan dengeyi tetiklemekte ve sonucunda ba\u011f\u0131ms\u0131zl\u0131k kayb\u0131na ve g\u00fcnl\u00fck ya\u015fam aktivitelerinin azalmas\u0131na neden olmaktad\u0131r (6). D\u00fc\u015fen hastalar\u0131n %12&#8217;sinin uzun s\u00fcreli bak\u0131mevi bak\u0131m\u0131na ihtiyac\u0131 oldu\u011fu bildirilmi\u015ftir (3). Basit bir yaralanma ile ciddi patolojilerin geli\u015fimi ile bu hastalar i\u00e7in \u2018Silver Trauma\u2018 tan\u0131m\u0131 yap\u0131lm\u0131\u015ft\u0131r. Silver travma, basit bir mekanizma sonras\u0131 yaralanma ciddiyet skoru (ISS) 15 \u00fczerinde oldu\u011fu durumlar\u0131 i\u00e7ermektedir&nbsp;(7). Bu nedenler ya\u015fl\u0131lar\u0131n&nbsp;d\u00fc\u015fmelerinin acil servislerdeki \u00f6nemini g\u00f6stermektedir.<\/p>\n\n\n\n<p><strong>II. D\u00fc\u015fme Risk Fakt\u00f6rleri<\/strong><\/p>\n\n\n\n<p>D\u00fc\u015fmeler genellikle, ya\u015fa ba\u011fl\u0131 denge, y\u00fcr\u00fcy\u00fc\u015f ve kardiyovask\u00fcler i\u015flevlerdeki azalmalar\u0131n \u00fczerine eklenen akut bir stres fakt\u00f6r\u00fcn\u00fcn (\u00f6rn. enfeksiyon, ila\u00e7, \u00e7evresel risk) etkisiyle olu\u015fur.&nbsp;&nbsp;\u00c7ok say\u0131da prospektif kohort \u00e7al\u0131\u015fmaya g\u00f6re, tekrar eden d\u00fc\u015fme \u00f6yk\u00fcs\u00fc olanlarda risk daha y\u00fcksektir. A\u015fa\u011f\u0131daki fakt\u00f6rler en s\u0131k ili\u015fkili olanlard\u0131r:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Ge\u00e7mi\u015fte d\u00fc\u015fme\u00a0\u00f6yk\u00fcs\u00fc\u00a0<\/li>\n\n\n\n<li>Kas g\u00fc\u00e7s\u00fczl\u00fc\u011f\u00fc,\u00a0\u00f6zellikle\u00a0alt ekstremitelerde<\/li>\n\n\n\n<li>\u0130leri ya\u015f<\/li>\n\n\n\n<li>Kad\u0131n cinsiyet<\/li>\n\n\n\n<li>Denge bozuklu\u011fu<\/li>\n\n\n\n<li>Bili\u015fsel bozulma<\/li>\n\n\n\n<li>Psikotrop ila\u00e7 kullan\u0131m\u0131<\/li>\n\n\n\n<li>Artrit, inme, ortostatik hipotansiyon<\/li>\n\n\n\n<li>Anemi, senkopla ili\u015fkili d\u00fc\u015fme,<\/li>\n<\/ul>\n\n\n\n<p>Ya\u015fl\u0131 bireylerde d\u00fc\u015fme riskini art\u0131ran \u00e7e\u015fitli fakt\u00f6rler sistematik olarak s\u0131n\u0131fland\u0131r\u0131labilir. Kad\u0131n cinsiyet, erkeklere k\u0131yasla belirgin bir risk fakt\u00f6r\u00fcd\u00fcr (2,8). Bunun d\u0131\u015f\u0131nda, ya\u015flanma s\u00fcreciyle birlikte duyusal sistemlerdeki bozulmalar da d\u00fc\u015fme riskini art\u0131rmaktad\u0131r. G\u00f6rme azalmas\u0131, vestib\u00fcler disfonksiyon ve proprioseptif yetersizlik gibi duyusal y\u0131k\u0131mlar; \u00f6zellikle \u00e7ok odakl\u0131 g\u00f6zl\u00fck kullan\u0131m\u0131 ve i\u015fitme kayb\u0131 ile birle\u015fti\u011finde \u00e7evresel etkile\u015fimi zorla\u015ft\u0131rarak post\u00fcral stabiliteyi bozar ve denge kayb\u0131na yol a\u00e7abilir. Ayr\u0131ca ortostatik hipotansiyon ve serebral perf\u00fczyon bozukluklar\u0131 da d\u00fc\u015fmeleri kolayla\u015ft\u0131ran \u00f6nemli fizyopatolojik mekanizmalard\u0131r. Parkinson hastal\u0131\u011f\u0131, osteoartrit, diyabet ve inme gibi kronik hastal\u0131klar ile kas-iskelet sistemi a\u011fr\u0131s\u0131 ve osteoporoz hem d\u00fc\u015fme hem de k\u0131r\u0131k a\u00e7\u0131s\u0131ndan \u00f6nemli risk olu\u015fturur. Psikotrop ila\u00e7lar, antikolinerjik ajanlar, antihipertansifler, polifarmasi ve ila\u00e7 dozundaki de\u011fi\u015fiklikler ise de\u011fi\u015ftirilebilir risk fakt\u00f6rleri aras\u0131nda yer al\u0131r. A\u015f\u0131r\u0131 alkol kullan\u0131m\u0131 ve uygun olmayan ayakkab\u0131 se\u00e7imi ise \u00f6nlenebilir \u00e7evresel riskler aras\u0131nda say\u0131lmaktad\u0131r (8-12).<\/p>\n\n\n\n<p><strong>III. D\u00fc\u015fmeye Ba\u011fl\u0131 Yaralanmalar<\/strong><\/p>\n\n\n\n<p>Ya\u015fl\u0131 bireylerde d\u00fc\u015fmelerin en ciddi sonu\u00e7lar\u0131 kal\u00e7a k\u0131r\u0131klar\u0131, kosta k\u0131r\u0131klar\u0131, el bile\u011fi ve vertebra k\u0131r\u0131klar\u0131, travmatik beyin hasar\u0131 ve yumu\u015fak doku yaralanmalar\u0131d\u0131r&nbsp;(13). Kal\u00e7a k\u0131r\u0131\u011f\u0131 sonras\u0131 bir y\u0131ll\u0131k mortalite %15\u201330 aras\u0131nda bildirilmektedir.&nbsp;Beyin atrofisi nedeniyle subdural hematom riski artmakta, antikoag\u00fclan kullan\u0131m\u0131 komplikasyon riskini daha da y\u00fckselmektedir&nbsp;(14).&nbsp;D\u00fc\u015fmenin d\u00fc\u015f\u00fck enerjili olmas\u0131, ciddi yaralanmalar\u0131 d\u0131\u015flamaz; maj\u00f6r torasik ya da abdominal travmalar geli\u015febilir (4).&nbsp;D\u00fc\u015fmeye ba\u011fl\u0131 hastaneye yat\u0131\u015f oran\u0131 %5 civar\u0131ndayken, %10&#8217;a yak\u0131n hastan\u0131n uzun d\u00f6nem bak\u0131ma ihtiyac\u0131 do\u011fmaktad\u0131r&nbsp;(3,14).<\/p>\n\n\n\n<p><strong>IV. D\u00fc\u015fme Sonras\u0131 Acil Serviste Yakla\u015f\u0131m<\/strong><\/p>\n\n\n\n<p>Acil serviste d\u00fc\u015fen ya\u015fl\u0131 bireyin de\u011ferlendirilmesi \u00f6zellikli yakla\u015f\u0131m gerektirir.&nbsp;De\u011ferlendirme yaln\u0131zca travmatik yaralanmalar\u0131 de\u011fil, ayn\u0131 zamanda d\u00fc\u015fmeye neden olan altta yatan etiyolojiyi de kapsamal\u0131d\u0131r&nbsp;(5,11,15). \u0130lk de\u011ferlendirme ABCDE yakla\u015f\u0131m\u0131 ile&nbsp;ba\u015flamal\u0131,&nbsp;vital bulgular ya\u015fl\u0131 hastalarda atipik seyredebildi\u011finden dikkatle yorumlanmal\u0131d\u0131r (11).&nbsp;Ya\u015fl\u0131larda travmatik yaralanmalar s\u0131kl\u0131kla sessiz seyredebilir; bu da klinik de\u011ferlendirmede \u00f6nemli bir tuzakt\u0131r.&nbsp;Beyin atrofisi kraniyal patolojilerin semptomlar\u0131n\u0131n gizli kalmas\u0131na neden olabilir, bat\u0131n yaralanmalar\u0131 semptomlar\u0131 de\u011fi\u015fen&nbsp;visseral&nbsp;sinir fizyoloji ile bat\u0131n hassasiyeti olu\u015fturmayabilir (5,16).&nbsp;<\/p>\n\n\n\n<p>D\u00fc\u015fme ile ba\u015fvuran bir ya\u015fl\u0131da anamnez sadece travmaya y\u00f6nelik olmamal\u0131d\u0131r. \u00d6ncesinde ya\u015fanan ba\u015f d\u00f6nmesi, \u00e7arp\u0131nt\u0131, bilin\u00e7 kayb\u0131, g\u00f6rme bulan\u0131kl\u0131\u011f\u0131, n\u00f6bet veya g\u00f6\u011f\u00fcs a\u011fr\u0131s\u0131 gibi semptomlar sorgulanmal\u0131d\u0131r. D\u00fc\u015fmenin neden olaca\u011f\u0131 yaralanmalar yan\u0131nda bir patolojiye sekonder d\u00fc\u015fme de meydana gelebilmektedir. Bu nedenle hastalar\u0131n ek tetkikleri ile- EKG, tam kan say\u0131m\u0131, elektrolit paneli ve g\u00f6r\u00fcnt\u00fcleme tetkikleri- altta yatan senkop, miyokard enfarkt\u00fcs\u00fc, aritmi, inme gibi nedenler d\u0131\u015flanmal\u0131d\u0131r (11).&nbsp;<\/p>\n\n\n\n<p>Olas\u0131 nedenler aras\u0131nda geriatrik sendromlar anamnez ve muayenede yer almal\u0131d\u0131r. Ya\u015fl\u0131 bireyin daha \u00f6nce d\u00fc\u015fme ataklar\u0131, d\u00fc\u015fme riski, d\u00fc\u015fme korkusu sorgulanmal\u0131d\u0131r. D\u00fc\u015fme nedenlerinden. \u00d6nemli olan polifarmasi ayr\u0131nt\u0131l\u0131 sorgulanmal\u0131d\u0131r. \u00d6zellikle antihipertansifler, benzodiazepinler, antidepresanlar ve antikolinerjik etkili ajanlar etiyolojide etkileri nedeniyle antikoag\u00fclan antiplatelet ajanlar ise olas\u0131 patoloji riskleri nedeniyle ayr\u0131nt\u0131l\u0131 de\u011ferlendirilmelidir. Sarkopeni, denge&nbsp;bozukluklar\u0131&nbsp;ayr\u0131nt\u0131l\u0131&nbsp;de\u011ferlendirilmelidir (11, 17).<\/p>\n\n\n\n<p>Acil servise d\u00fc\u015fme ile ba\u015fvuran hastalar i\u00e7in CDC taraf\u0131ndan sa\u011fl\u0131k profesyonelleri ve de hastalar i\u00e7in bilgilendirmeler yapmaktad\u0131r. Sa\u011fl\u0131k profesyonelleri i\u00e7in d\u00fc\u015fen bir hasta i\u00e7in \u00f6nerdi\u011fi algoritma tan\u0131mlanm\u0131\u015ft\u0131r. Bu algoritmada d\u00fc\u015fme riski belirlenen hastan\u0131n g\u00fc\u00e7 ve denge testlerini yap\u0131lmas\u0131n\u0131 \u00f6nermektedir. Acil serviste de kolayl\u0131kla yap\u0131labilecek ad\u0131m testi, sandalye testi, d\u00f6rt a\u015famal\u0131 denge testi bunlardan \u00f6nerilenlerdir. Hastan\u0131n polifarmasi, g\u00f6rme keskinli\u011fi, ev g\u00fcvenli\u011fi, ortostatik kan bas\u0131nc\u0131n\u0131n, ayak sa\u011fl\u0131\u011f\u0131n\u0131n, ek hastal\u0131klar\u0131n sorgulanmas\u0131n\u0131 \u00f6nerilmektedir&nbsp;(3).&nbsp;<\/p>\n\n\n\n<p>Ya\u015fl\u0131 hastalar\u0131n basit d\u00fc\u015fmeye ba\u011fl\u0131 yaralanmalar\u0131 yat\u0131\u015f ya da operasyon gereksinimi olmasa da komplikasyon geli\u015fimi nedeniyle acil serviste izlem gerektirir. Kafa travmas\u0131 olan ya\u015fl\u0131 bireylerin izlemde subdural geli\u015fim riski vard\u0131r (18). Toraks travmas\u0131na ba\u011fl\u0131 patoloji saptanmasa dahi yeterli a\u011fr\u0131 palyasyonu sa\u011flanmad\u0131\u011f\u0131nda geli\u015febilecek atelektazi ve pn\u00f6moniler yine acil servis ba\u015fvurusu ile sonu\u00e7lanacakt\u0131r (19). Bat\u0131n muayenesinin izlenmesi, ya\u015fa ba\u011fl\u0131 de\u011fi\u015fen fizyolojik yan\u0131tlar nedeniyle ya\u015fl\u0131 hastalarda s\u0131n\u0131rl\u0131 anlam ta\u015f\u0131maktad\u0131r (16).<\/p>\n\n\n\n<p><strong>V. Acil Serviste Koruyucu Stratejiler ve Uygulanan Modeller<\/strong><\/p>\n\n\n\n<p>D\u00fc\u015fme sonras\u0131 ba\u015fvurular\u0131n ve tekrarlayan ba\u015fvurular\u0131n acil servise olmas\u0131, d\u00fc\u015fmeye ba\u011fl\u0131 yaralanmalar\u0131n komplikasyonlar\u0131n\u0131n acil serviste y\u00f6netilmesi, d\u00fc\u015fme \u00f6nleyici politikalar\u0131n acil servislerde olu\u015fturulmas\u0131 i\u00e7in ad\u0131m at\u0131lmas\u0131n\u0131 gerekli k\u0131lm\u0131\u015ft\u0131r. D\u00fc\u015fme ile ba\u015fvurular\u0131n acil servislere oldu\u011fu d\u00fc\u015f\u00fcn\u00fcld\u00fc\u011f\u00fcnde koruyucu stratejilerin geli\u015ftirilmesi de acil servis taburculu\u011fu sonras\u0131nda ba\u015flamas\u0131 vurgulanmakta ve konu ile ilgili \u00e7al\u0131\u015fmalar yay\u0131nlanmaktad\u0131r (20,21). D\u00fc\u015fme riskinin ve d\u00fc\u015fme korkusunun belirlenmesi ilk ad\u0131m\u0131 olu\u015fturur. Risk fakt\u00f6rlerinin belirlenmesi \u00f6zellikle taburculuk \u00f6ncesi ila\u00e7lar\u0131n d\u00fczenlenmesi d\u00fc\u015fme riskini belirgin azaltmaktad\u0131r (15). 2012&#8217;de yap\u0131lan bir Cochrane \u0130ncelemesi, d\u00fc\u015fme oran\u0131n\u0131 azaltan birka\u00e7 m\u00fcdahale bulmu\u015f ve acil t\u0131p y\u00f6netiminde &#8216;yararl\u0131 olabilecek&#8217; m\u00fcdahalelerin d\u00fc\u015f\u00fcn\u00fclebilece\u011fini ve bireysel risk de\u011ferlendirmesi, ev g\u00fcvenli\u011fi de\u011ferlendirmesi ve de\u011fi\u015fiklik, grup ve ev tabanl\u0131 egzersiz programlar\u0131 ve psikotropik ila\u00e7lar\u0131n kademeli olarak kesilmesini i\u00e7eren \u00e7oklu fakt\u00f6riyel m\u00fcdahaleleri i\u00e7erebilece\u011fini \u00f6nermi\u015ftir (21). Giovanni ve arkada\u015flar\u0131, fiziksel aktivite, teknoloji ve fizyolojik ve kognitif d\u00fczenlemelerin d\u00fc\u015fmeyi \u00f6nleyece\u011fini belirtmektedir (11).<\/p>\n\n\n\n<p>Harper ve arkada\u015flar\u0131, acil serviste&nbsp;taburculuk sonras\u0131-e\u011fitim, egzersiz, ev g\u00fcvenli\u011finin sa\u011flanmas\u0131, i\u015f terapisi gibi \u00e7oklu d\u00fczenlemeler-&nbsp;d\u00fc\u015fme \u00f6nleyici m\u00fcdahalelerin tekrarlayan d\u00fc\u015fme oranlar\u0131n\u0131 azaltmada etkili olmad\u0131\u011f\u0131n\u0131 ancak hasta \u00fczerinde olumlu etkileri oldu\u011funu belirtmi\u015ftir (20). Ancak&nbsp;e\u011fitimin&nbsp;tek&nbsp;ba\u015f\u0131na&nbsp;%10 etkili oldu\u011funu vurgulam\u0131\u015ft\u0131r. Goldberg ve arkada\u015flar\u0131, denge ve kuvvet de\u011ferlendirmeleri ile eczac\u0131 incelemesini takiben uygulanan ev d\u00fczenlemeleri, fiziksel aktivite ve i\u015f terapisi gibi m\u00fcdahalelerin \u00fc\u00e7 ay i\u00e7inde d\u00fc\u015fme oranlar\u0131n\u0131 azaltt\u0131\u011f\u0131n\u0131 bildirmi\u015ftir (22). Morello sistematik derlemesinde e\u011fitim, ev d\u00fczenlemeleri, sa\u011fl\u0131k kurulu\u015funa y\u00f6nlendirme ile d\u00fczenlemeleri, cihaz kullan\u0131mlar\u0131n\u0131n da yer ald\u0131\u011f\u0131 acil servis d\u00fc\u015fme \u00f6nleme modelleri ile pop\u00fclasyona g\u00f6re d\u00fczenleme yap\u0131ld\u0131\u011f\u0131nda etkili olabilece\u011fini belirtmektedir (23). SeFallED \u00e7al\u0131\u015fmas\u0131, kompleks acil servis protokollerinin d\u00fc\u015fme \u00f6nlemede etkili oldu\u011funa dair umut verici sonu\u00e7lar ortaya koymu\u015ftur (24).<\/p>\n\n\n\n<p>CDC taraf\u0131ndan geli\u015ftirilen STEADI (Stopping Elderly Accidents, Deaths &amp; Injuries) algoritmas\u0131, riskli hastalar\u0131 tan\u0131mak ve m\u00fcdahalede bulunmak i\u00e7in kullan\u0131lmaktad\u0131r. Bu algoritmas\u0131, kapsaml\u0131 d\u00fc\u015fme riski de\u011ferlendirmeleri (takip ile veya takipsiz), egzersiz, ila\u00e7 y\u00f6netimi, d\u00fc\u015fme riski e\u011fitimi, davran\u0131\u015f de\u011fi\u015fikli\u011fi ve ev tehlike azalt\u0131m\u0131 gibi tek ba\u015f\u0131na stratejileri veya en az iki farkl\u0131 stratejiyi i\u00e7eren \u00e7oklu fakt\u00f6riyel m\u00fcdahaleleri i\u00e7erir (25). Ev ve \u00e7evresel d\u00fczenlemeler, takip sistemleri, giyilebilir teknolojiler ve egzersiz programlar\u0131 gibi stratejilerle desteklenen d\u00fc\u015fme \u00f6nleyici politikalar\u0131n olu\u015fturulmas\u0131 \u00f6nerilmektedir.<\/p>\n\n\n\n<p>Ya\u015fl\u0131 bireylerde d\u00fc\u015fmenin \u00f6nlenmesine y\u00f6nelik m\u00fcdahalelerin, acil servis ba\u015fvurusuyla ba\u015flamas\u0131 gerekti\u011fi ve bu s\u00fcrecin \u00e7ok bile\u015fenli, bireyselle\u015ftirilmi\u015f yakla\u015f\u0131mlarla s\u00fcrd\u00fcr\u00fclmesi gerekti\u011fi \u00f6nerilmektedir.&nbsp;<\/p>\n\n\n\n<p><strong>Kaynak\u00e7a<\/strong><\/p>\n\n\n\n<ol class=\"wp-block-list\">\n<li>World Health Organization. Falls: Key Facts. Published 2021. Accessed July 14, 2025. https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/falls<\/li>\n\n\n\n<li>Greenberg MR, Goodheart V, Jacoby JL, et al. Emergency Department Stopping Elderly Accidents, Deaths and Injuries (ED STEADI) Program. J Emerg Med. 2020;59(1):1-11. doi:10.1016\/j.jemermed.2020.04.019<\/li>\n\n\n\n<li>Centers for Disease Control and Prevention. Older Adult Falls Data. Accessed October 28, 2024. https:\/\/www.cdc.gov\/falls\/data-research\/index.html<\/li>\n\n\n\n<li>Spaniolas K, Cheng JD, Gestring ML, et al. Ground level falls are associated with significant mortality in elderly patients. J Trauma. 2010;69(4):821-825. doi:10.1097\/TA.0b013e3181efc6c6<\/li>\n\n\n\n<li>Aschkenasy MT, Rothenhaus TC. Trauma and falls in the elderly. Emerg Med Clin North Am. 2006;24(2):413-429. doi:10.1016\/j.emc.2006.01.005<\/li>\n\n\n\n<li>Kiel DP. Falls in older persons: risk factors and patient evaluation. UpToDate. Updated June 10, 2025. Accessed July 14, 2025. https:\/\/www.uptodate.com\/contents\/falls-in-older-persons-risk-factors-and-patient-evaluation<\/li>\n\n\n\n<li>Curtis K, Mitchell R, Chong SS, Black DA. Older people and trauma: A trauma registry review. Injury. 2020;51(3):650-655. doi:10.1016\/j.injury.2019.12.010<\/li>\n\n\n\n<li>Martins R, Carvalho N, Batista S, Dinis A. Falls in Elderly: Study of the Prevalence and Associated Factors. Eur J Dev Stud. 2022;2(3):12-17. doi:10.24018\/ejdevelop.2022.2.3.92<\/li>\n\n\n\n<li>Melzer I, Freiberger E, Britting S, et al. Characteristics of falls among community-dwelling older adults: The SCOPE Study. Gerontology. 2025;71(4):253-272. doi:10.1159\/000544962<\/li>\n\n\n\n<li>Xu Q, Ou X, Li J. The risk of falls among the aging population: A systematic review and meta-analysis. Front Public Health. 2022;10:902599. doi:10.3389\/fpubh.2022.902599<\/li>\n<\/ol>\n\n\n\n<ol class=\"wp-block-list\">\n<li>Giovannini S, Brau F, Galluzzo V, et al. Falls among older adults: Screening, identification, rehabilitation, and management. Appl Sci. 2022;12(15):7934. doi:10.3390\/app12157934<\/li>\n\n\n\n<li>Casey MF, Niznik J, Anton G, et al. Prevalence of fall risk-increasing drugs in older adults presenting with falls to the emergency department. Acad Emerg Med. 2023;30(11):1170-1173. doi:10.1111\/acem.14743<\/li>\n\n\n\n<li>Bergeron E, Clement J, Lavoie A, et al. A simple fall in the elderly: not so simple. J Trauma. 2006;60(2):268-273. doi:10.1097\/01.ta.0000197651.00482.c5<\/li>\n\n\n\n<li>Rau CS, Lin TS, Wu SC, et al. Geriatric hospitalizations in fall-related injuries. Scand J Trauma Resusc Emerg Med. 2014;22:63. doi:10.1186\/s13049-014-0063-1<\/li>\n\n\n\n<li>Rubenstein LZ. Falls in older people: epidemiology, risk factors and strategies for prevention. Age Ageing. 2006;35(Suppl 2):ii37-ii41. doi:10.1093\/ageing\/afl084<\/li>\n\n\n\n<li>Hagan AK, et al. Physical exam is not an accurate predictor of injury in geriatric patients with low-energy blunt trauma. Ann Med Surg. 2023;83:103070. doi:10.1016\/j.amsu.2023.103070<\/li>\n\n\n\n<li>Ambrose AF, Paul G, Hausdorff JM. Risk factors for falls among older adults: a review of the literature. Maturitas. 2013;75(1):51-61. doi:10.1016\/j.maturitas.2013.02.009<\/li>\n\n\n\n<li>Wada K, et al. Incidence of chronic subdural hematoma after mild head trauma in older adults. World Neurosurg. 2022;160:e123-e130. doi:10.1016\/j.wneu.2021.10.045<\/li>\n\n\n\n<li>Van Vledder MG, Kwakernaak V, Hagenaars T, et al. Patterns of injury and outcomes in the elderly patient with rib fractures: a multicenter observational study. Eur J Trauma Emerg Surg. 2019;45(4):575-583. doi:10.1007\/s00068-018-0969-9<\/li>\n\n\n\n<li>Harper KJ, Arendts G, Barton AD, Celenza A. Providing fall prevention services in the emergency department: Is it effective? A systematic review and meta-analysis. Australas J Ageing. 2021;40:116-124.<\/li>\n\n\n\n<li>Gillespie LD, Robertson MC, Gillespie WJ, et al. Interventions for preventing falls in elderly people. Cochrane Database Syst Rev. 2012;9:CD007146.<\/li>\n\n\n\n<li>Goldberg EM, Resnik L, Marks SJ, Merchant RC. GAPcare: the Geriatric Acute and Post-acute Fall Prevention Intervention\u2014a pilot investigation of an emergency department-based fall prevention program for community-dwelling older adults. Pilot Feasibility Stud. 2019;5:106. doi:10.1186\/s40814-019-0491-9<\/li>\n<\/ol>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Morello RT, Soh SE, Behm K, et al. Multifactorial falls prevention programmes for older adults presenting to the emergency department with a fall: systematic review and meta-analysis. Inj Prev. 2019;25(6):557-564. doi:10.1136\/injuryprev-2019-043214<\/li>\n\n\n\n<li>Stuckenschneider T, Koschate J, Dunker E, et al. Sentinel fall presenting to the emergency department (SeFallED) \u2013 protocol of a complex study including long-term observation of functional trajectories after a fall, exploration of specific fall risk factors, and patients\u2019 views on falls prevention. BMC Geriatr. 2022;22:594. doi:10.1186\/s12877-022-03261-7<\/li>\n\n\n\n<li>Centers for Disease Control and Prevention. STEADI (Stopping Elderly Accidents, Deaths &amp; Injuries) Tool Kit for Health Care Providers. Accessed April 22, 2024. https:\/\/www.cdc.gov\/steadi\/media\/pdfs\/steadi-pocketguide-508.pdf<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>I. Ya\u015fl\u0131larda D\u00fc\u015fme: Tan\u0131m ve Epidemiyoloji D\u00fc\u015fme, D\u00fcnya Sa\u011fl\u0131k \u00d6rg\u00fct\u00fc taraf\u0131ndan bir ki\u015finin istemsiz olarak yere veya daha d\u00fc\u015f\u00fck bir seviyeye inmesi&hellip;<\/p>\n","protected":false},"author":1185,"featured_media":703,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"inline_featured_image":false,"_lmt_disableupdate":"","_lmt_disable":"","footnotes":""},"categories":[1],"tags":[10020,10033,10018],"class_list":["post-702","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-genel","tag-acil-tip","tag-dusme","tag-geriatri"],"acf":[],"_links":{"self":[{"href":"https:\/\/tatd.org.tr\/geriatri\/wp-json\/wp\/v2\/posts\/702","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/tatd.org.tr\/geriatri\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/tatd.org.tr\/geriatri\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/tatd.org.tr\/geriatri\/wp-json\/wp\/v2\/users\/1185"}],"replies":[{"embeddable":true,"href":"https:\/\/tatd.org.tr\/geriatri\/wp-json\/wp\/v2\/comments?post=702"}],"version-history":[{"count":0,"href":"https:\/\/tatd.org.tr\/geriatri\/wp-json\/wp\/v2\/posts\/702\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/tatd.org.tr\/geriatri\/wp-json\/wp\/v2\/media\/703"}],"wp:attachment":[{"href":"https:\/\/tatd.org.tr\/geriatri\/wp-json\/wp\/v2\/media?parent=702"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/tatd.org.tr\/geriatri\/wp-json\/wp\/v2\/categories?post=702"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/tatd.org.tr\/geriatri\/wp-json\/wp\/v2\/tags?post=702"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}