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Invited Commentary
October 28, 2013

Prognosis for Recovery After Injurious Falls: Clinical and Policy Implications of Varying Definitions of Recovery

Author Affiliations
  • 1Division of Geriatrics and Gerontology, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
  • 2VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania
JAMA Intern Med. 2013;173(19):1786-1787. doi:10.1001/jamainternmed.2013.8252

Hip fractures and other serious injuries attributed to falls have dire consequences for increased mortality and decreased function.1 Although prevention is surely the best strategy, substantial resources are justifiably invested in promoting recovery after such events—but who should receive such costly interventions? Clearly, treatment should be aligned with expectation of benefit. Common markers of vulnerability among the aged, such as disability and cognitive impairment, are strongly associated with worse survival and functional decline after hip fracture and other adverse health events associated with aging, including hospitalization and cancer.2-4 Given that ethical decision making should be driven by the goals and best interests of the patient, what is the best approach to patient care for an older adult after a serious fall injury?

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