Whole-Body Point-of-Care Ultrasound in Older Adults Presenting to the Emergency Department After a Fall

NCT07886164 | Recruiting

• 1 other identifier: 2026-192
• Study Type: observational
• Target: 105
• Locations: 1 country
• Sites: 1

Brief Summary

Falls are one of the most common reasons older adults visit the emergency department. In many older patients, a fall that looks "mechanical" is actually caused by an underlying medical problem such as syncope, heart disease, dehydration or blood clots, and the history is often unreliable. This single-center prospective study will evaluate whether a structured whole-body point-of-care ultrasound (POCUS) examination performed at the bedside changes how emergency physicians manage patients aged 65 years and older who come to the emergency department after a ground-level fall. The main question is how often POCUS findings change the physician's working diagnosis, consultation requests, additional tests, procedures, or admission/discharge decisions. Patients will also be followed for one week for death and repeat emergency department visits.

Conditions

Accidental Falls; Aged; Syncope

Keywords

Point-of-Care Ultrasound; POCUS; Geriatric Emergency Medicine; Falls in the Elderly; Emergency Department; Carotid Plaque; Focused Cardiac Ultrasound; Frailty

Outcome Measures

Primary Outcomes (1)

• Rate of Change in Emergency Department Management After Whole-Body POCUS

  Proportion of patients in whom the treating physician reports at least one change after POCUS in: working diagnosis regarding the cause of the fall, consultation request, additional test request, need for a minor or major procedure, or disposition decision (admission/discharge/transfer), compared with the plan recorded before POCUS.

  During the emergency department stay (up to 24 hours)

Secondary Outcomes (7)

• Change in Working Diagnosis

  During the emergency department stay (up to 24 hours)

• Change in Consultation Requests

  During the emergency department stay (up to 24 hours)

• Change in Disposition Decision

  During the emergency department stay (up to 24 hours)

• Need for Minor or Major Procedures

  During the emergency department stay (up to 24 hours)

• Contribution of POCUS to Identifying the Cause of the Fall

  During the emergency department stay (up to 24 hours)

Study Arms (1)

Older adults after a ground-level fall

Patients aged 65 years and older presenting to the adult emergency department after a ground-level fall, who undergo a structured whole-body point-of-care ultrasound examination in addition to standard emergency department care.

Diagnostic Test: Whole-body point-of-care ultrasound (POCUS)

Interventions

Whole-body point-of-care ultrasound (POCUS) DIAGNOSTIC_TEST

Structured bedside ultrasound examination performed by trained emergency medicine residents who are blinded to clinical information: carotid arteries, inferior vena cava, aortic root and abdominal aorta, FAST, focused cardiac ultrasound, lung ultrasound, quadriceps muscle thickness and, when indicated, 3-point compression ultrasound for deep vein thrombosis. Findings are reported to the treating physician, who makes all clinical decisions.

Older adults after a ground-level fall

Eligibility Criteria

• Age: 65 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Patients aged 65 years and older presenting to the adult emergency department of Kocaeli City Hospital (Kocaeli, Türkiye) after a ground-level fall.

You may qualify if:

• Age 65 years or older
• Presentation to the emergency department after a ground-level fall
• No condition preventing whole-body ultrasound (no amputation preventing quadriceps muscle measurement; no open wound or burn on the chest or abdomen preventing cardiac ultrasound or FAST; no neck lesion preventing carotid ultrasound)
• Written informed consent given by the patient or a legal representative

You may not qualify if:

• High-energy trauma mechanism (e.g., traffic accident, fall from height, crush injury)
• Hemodynamic instability requiring priority resuscitation
• Withdrawal of consent
• Loss to follow-up or missing outcome data

Sponsors & Collaborators

• Kocaeli City Hospital: lead

Study Sites (1)

Kocaeli City Hospital, Department of Emergency Medicine

İzmit, Kocaeli, 41060, Turkey (Türkiye)

RECRUITING

Related Publications (3)

• O' Brien H, Anne Kenny R. Syncope in the Elderly. Eur Cardiol. 2014 Jul;9(1):28-36. doi: 10.15420/ecr.2014.9.1.28.

  PMID: 30310482 BACKGROUND

• Latham LP, Ackroyd-Stolarz S. Emergency department utilization by older adults: a descriptive study. Can Geriatr J. 2014 Dec 2;17(4):118-25. doi: 10.5770/cgj.17.108. eCollection 2014 Dec.

  PMID: 25452824 BACKGROUND

• Ucar G, Aksay E, Bayram B, Guzelce MC, Ergun YK. The diagnostic efficiency of whole-body bedside ultrasonography protocol for syncope patients in the emergency department. Am J Emerg Med. 2023 May;67:17-23. doi: 10.1016/j.ajem.2023.01.043. Epub 2023 Feb 3.

  PMID: 36774906 BACKGROUND

MeSH Terms

Conditions

Syncope; Emergencies; Frailty

Condition Hierarchy (Ancestors)

Unconsciousness; Consciousness Disorders; Neurobehavioral Manifestations; Neurologic Manifestations; Nervous System Diseases; Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Disease Attributes; Pathologic Processes

Study Officials

• Asım Enes Özbek, MD, Assoc. Prof.

  Kocaeli City Hospital

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Melike Yılmaz, MD

CONTACT

+90 538 892 99 06; md.melikeyilmaz@gmail.com

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER GOV
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: October 14, 2026
• First Posted: October 21, 2026
• Study Start: October 12, 2026
• Primary Completion (Estimated): October 1, 2027
• Study Completion (Estimated): December 1, 2027
• Last Updated: October 21, 2026

Record last verified: 2026-10

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)