背景：老年人跌倒已是全球性的健康議題，跌倒的後續影響不僅是醫療費用的支出，更易造成老年人失能、憂鬱，甚至死亡，也增加了照顧者的負擔。急診為老年緊急醫療的第一線，超過ㄧ半的老年人跌倒至急診就醫治療後即出院，往往因潛在的跌倒風險而再度跌倒就醫，甚至因跌倒造成的合併症需住院治療。若能在急診第一線即進行跌倒危險因子評估，並可提供介入措施，預防反覆跌倒的情形。
目的：分析反覆跌倒的危險因子，作為急診跌倒評估與預防措施之參考。
方法：以南部某醫學中心的急診就醫病歷為收案來源，採回溯性病歷回顧，以自擬式結構問卷包括人口學資料、跌倒史、醫療、藥物及社會層面進行資料登錄。為了資料的完整性，另向個案或家屬以電話訪談蒐集資料。
研究結果與臨床應用：多數老年人跌倒後至急診就醫，無論是反覆跌倒或單次跌倒，其共同診斷以頭部創傷、暈眩為主。數據顯示超過ㄧ半以上的老年人接受治療後即出院返家，並未經過危險因子評估或轉介諮詢。75%反覆跌倒的老年人於離院後六個月再度入院，而反覆跌倒的老年人比單次跌倒、無跌倒經驗者需支付更高的醫療費用。其主要的危險因子為心血管、神經系統疾病、步態不穩、鎮靜安眠藥物。此結果可提供臨床醫護人員ㄧ個跌倒評估參考，篩檢反覆跌倒的高危險群，以減少老年人反覆跌倒再入院機率。

Background: Falls are a global health concern in the elderly population. The results of falls include increasing in healthcare spending and caregivers’ burdens, functional disability, depression and even death. Though emergency departments（EDs）are the initial places to provide medical management, lack of enough high risks assessments and interventions at the ED frequently resulted in more falls after discharge. Furthermore, risk factors among those elderly persons presenting to EDs with recurrent fall were not well developed before.
Purpose: The study is designed to determine risk factors for elderly patients with recurrent fall within one year presenting to emergency room.
Method: A retrospective chart review was conducted for elderly patients who presented to the ED of a medical center in southern Taiwan with recurrent fall within one year from 2010 through 2012. Structure questionnaires were developed to collect data, which includes demographic characteristics, underlying diseases, medication, fall history and social factors. Telephone interviews were conducted to have more complete information if needed.
Results and future implication: The most common diagnoses for elderly individuals presenting to the ED were head injury and dizziness. Seventy-five percent of the elderly patients with recurrent fall returned to the ED after the six months following the frequency of readmission. The cost for fall-related injuries for elderly with recurrent fall was much more than that for elderly with single fall event and elderly who have never fell before within 6 months. Most patients discharged directly from the ED did not receive fall-related risk factors assessment or preventing education. The risk factors of recurrent fall were cardiac vascular disease, neurological disease, unsteady gait, and sedative drugs. The information can be helpful to screen high risk multiple falls elderly and the more fall interventions are necessary to conduct for reducing the further events at the ED.

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