AGEM Author Spotlight May 2020
Published Work by AGEM Members
AGEM Author Spotlight: Kenneth Frumkin, PhD, MD, FACEP
Toppling Oranges: Death, Disability, Decline and Readmission of Community-Dwelling Elderly Patients Following an Emergency Department Visit.
Frumkin, K. J Emerg Med. 2020 Feb;58(2):339-345. PMID: 32005609
Article Abstract: Every emergency department (ED) faces both a rising tide and a revolving door of elderly patients. Unplanned short-term returns after a recent ED evaluation or hospital admission are sentinel events. Consequences include substantial functional decline, reduced health-related quality of life, and increased risk of dependency or death. Returning families, unaware of the significant likelihood of deterioration after an ED or hospital discharge, often harbor suspicions that something was missed. Literature describing the significant likelihood of functional decline in elderly patients after ED or hospital discharge is presented. Suggestions for incorporating the potential for subsequent deterioration into the evaluation of elderly ED patients and the discussions surrounding disposition decisions are included.
In addition to impacting patients and families, posthospitalization decline and short-term readmissions create serious burdens for hospitals and their EDs. Education, vigilance, specialized geriatric EDs, dedicated inpatient units, and ED access to outpatient services for the elderly can aid in the recognition and mitigation of postvisit functional decline and associated returns. Financial incentives for reducing short-term readmissions can translate into novel approaches and referral arrangements.
Currently, and for the foreseeable future, EDs are integral to predicting, identifying, and preventing functional decline in the elderly. For now, we are all Geriatric EDs.
Short Bio: Dr. Frumkin completed his PhD in physiological psychology at McGill University and his emergency medicine residency at Brooke Army Medical Center. Half of his career has been spent in busy community hospitals; the other half in military emergency medicine residency programs. He currently serves as volunteer faculty in the Emergency Medicine Department, Naval Medical Center, Portsmouth, Virginia. He has been an examiner for the American Board of Emergency Medicine and consulting reviewer for five emergency medicine journals. Much of his published work has been intended to bring unfamiliar topics to a wider audience within the specialty. Dr. Frumkin’s strong interest in geriatric emergency medicine comes from his credible expectation of becoming a geriatric emergency patient.
The views expressed are my own, and do not necessarily reflect the official policy or position of the Department of the Navy, Department of Defense, or the United States Government.
Previous AGEM Author Spotlight Articles
February 2020
Goldberg EM, Marks SJ, Ilegbusi A, Resnik L, Strauss DH, Merchant RC.
J Am Geriatr Soc. 2020 Jan;68(1):198-206. doi: 10.1111/jgs.16210. Epub 2019 Oct 17.
PMID: 31621901
January 2020
Concepts in Practice: Geriatric Emergency Departments.
Southerland LT, Lo AX, Biese K, Arendts G, Banerjee J, Hwang U, Dresden S, Argento V, Kennedy M, Shenvi CL, Carpenter CR. Ann Emerg Med. 2020 Feb;75(2):162-170.
November 2019
Ouchi, K. et. al. (2019) JAMA Network Open.
August 2019
Managing the Elderly Emergency Department Patient
Shenvi, C. L., & Platts-Mills, T. F. (2019) Annals of Emergency Medicine.
February 2019
Exploring Older Adult ED Fall Patients' Understanding of Their Fall: A Qualitative Study.
Shankar KN, Taylor D, Rizzo CT, Liu SW. Geriatric Orthopaedic Surgery & Rehabilitation. 2017 Dec;8(4):231-237
November 2018
Common Medication Management Approaches for Older Adults in the Emergency Department.
Dresden SM, Allen K, Lyden AE. Clinics in Geriatric Medicine. 2018 Aug;34(3):415-433
April 2018
Telephone Followâ€Up for Older Adults Discharged to Home from the Emergency Department: A Pragmatic Randomized Controlled Trial
Biese KJ, Busby-Whitehead J, Cai J, Stearns SC, Roberts E, Mihas P, Emmet D, Zhou Q, Farmer F, Kizer JS.Journal of the American Geriatrics Society. 2018 March; 66(3): 452-458
March 2018
An Emergency Department Observation Unit Is a Feasible Setting for Multidisciplinary Geriatric Assessments in Compliance With the Geriatric Emergency Department Guidelines
Southerland LT, Vargas AJ, Nagaraj L, Gure TR, Caterino JM. Academic Emergency Medicine. 2018 Jan; 25(1): 76-82
February 2018
Geriatric Emergency Department Innovations: Transitional Care Nurses and Hospital Use
Hwang U, Dresden SM, Rosenberg MS, Garrido MM, Loo G, Sze J, Gravenor S, Courtney DM, Kang R, Zhu CW, Vargas-Torres C, Grudzen CR, Richardson LD; GEDI WISE Investigators
January 2018
Major trauma in the older patient: Evolving trauma care beyond management of bumps and bruises
December 2017
Emergency Department Pain Management Following Implementation of a Geriatric Hip Fracture Program
Casey SD, Stevenson DE, Mumma BE, Slee C, Wolinsky PR, Hirsch CH,Tyler K
November 2017
Emergency Medical Services Perspectives on Identifying and Reporting Victims of Elder Abuse
Rosen T; Lien C, Stern ME, Bloemen EM, Mysliwiec R, McCarthy TJ, Clark S, Mulcare MR, Ribaudo DS, Lachs MS, Pillemer K, Flomenbaum NE
October 2017
Discrepancies between information provided and information required by emergency physicians for long-term care patients
Evans CS; Timothy Platts-Mills, MD, MSc; Fernandez AR; Grover JM; Cabanas JG; Patel MD; Vilke GM; Brice JH
September 2017
Discrepancies between information provided and information required by emergency physicians for long-term care patients
Parshar R, McLeod S,Don Melady, MSc, MD,
August 2017
The Effect of Older Age on EMS Use for Transportation to an Emergency Department
Manish N. Shah, MD, MPH; Jones CMC; Wasserman EB, Li T, Amidon A, Abbot, M
July 2017
Serious conditions for ED elderly fall patients: a secondary analysis of the Basel Non-Specific Complaints study
Shan W. Liu MD, SD; Jiraporn Sri-On MD, Gregory Philip Tirrell MS, Christian Nickel MD, Roland Bingisser MD
June 2017
Accuracy of Current Diagnostic Criteria for Acute Bacterial Infection in Older Adults in the Emergency Department
Jeffrey Caterino, MD; Robert Leininger, MD; David M. Kline, PhD; Lauren T. Southerland, MD; Salman Khaliqdina, MBBS; Christopher W. Baugh, MD, MBA; Daniel J. Pallin, MD, MPH; Kurt B. Stevenson, MD, MPH
May 2017
Factors Associated with Hospital Admission for Older Adults Receiving Care in U.S. Emergency Departments
Alexander X. Lo, MD, PhD; Kellie L. Flood, MD; Kevin Biese, MD, MAT; Timothy F. Platts-Mills, MD, MSc; John P. Donnelly, MSPH; Christoper R. Carpenter, MD, MS
April 2017
Emergency Department Visits Without Hospitalization Are Associated With Functional Decline in Older Persons
Justine M. Nagurney, MD; William Fleischman, MD, MHS; Ling Han, MD, PhD; Linda Leo-Summers, MPH, Heather G. Allore, PhD; Thomas M. Gill, MD
Improving Pain Relief in Elder Patients (I-PREP): An Emergency Department Education and Quality Intervention
Teresita M. Hogan, MD; Michael D. Howell, MD; John F. Cursio, PhD; Alexandra Wong, BA; William Dale, MD
March 2017
Exploring Delirium's Heterogeneity: Association Between Arousal Subtypes at Initial Presentation and 6-Month Mortality in Older Emergency Department Patients
Jin H. Han, MD, MSc; Nathan E. Brummel, MD, MSCI; Rameela Chandrasekhar, PhD; Jo Ellen Wilson, MD; Xulei Liu, MS; Eduard E. Vasilevskis, MD, MPH; Timothy D. Girard, MD, MSCI; Maria E. Carlo, MD; Robert S. Dittus, MD, MPH; John F. Schnelle, PhD; E. Wesley Ely, MD, MPH
December 2016
Feasibility of nurses measuring gait speed in older community-dwelling Emergency Department patients
Paula W. Tucker, DNP, FNP-BC; Dian Dowling Evans, PhD, FNP-BC, ENP-BC, FAANP; Carolyn K. Clevenger, DNP, RN, GNP-BC, AGPCNP-BC, FAANP; Michelle Ardisson, DNP, RN, ACNP-BC; Ula Hwang, MD, MPH, FACEP
October 2016
Effect of Geriatric-Specific Trauma Triage Criteria on Outcomes in Injured Older Adults: A Statewide Retrospective Cohort Study
Jeffrey M. Caterino, MD, MPH; Nicole Brown, MS; Maya W Hamilton, BA; Brian Ichwan, MD; Salman Khaliqdina, MBBS; David C. Evans, MD; Subrahmanyan Darbha, MS; Ashish R. Panchal, MD, PhD; Manish N. Shah, MD, MPH
October 2013
Geriatric Department Guidelines
Mark S. Rosenberg, DO, MBA, FACEP, Christopher R. Carpenter, MD, MSc, FACEP, Marilyn Bromley, RN, BS, Jeffrey M. Caterino, MD, MPH, FACEP, Audrey Chun, MD, Lowell Gerson, PhD, Jason Greenspan, MD, FACEP, Ula Hwang, MD, FACEP, David P. John, MD, FACEP, Joelle Lichtman, MA, William L. Lyons, MD, Betty Mortensen, RN, MS, BSN, FACHE, Timothy F. Platts-Mills, MD, MSc, Luna C. Ragsdale, MD, MPH, FACEP, Julie Rispoli, David C. Seaberg, MD, CPE, FACEP, Scott T. Wilber, MD, MPH, FACEP