Published Work by AGEM Members

 

AGEM Author Spotlight: Kenneth Frumkin, PhD, MD, FACEP

Dr. K Frumkin

 

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

GAPcare: The Geriatric Acute and Post-Acute Fall Prevention Intervention in the Emergency Department: Preliminary Data.

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 LTLo AXBiese KArendts GBanerjee JHwang UDresden SArgento VKennedy MShenvi CLCarpenter CRAnn Emerg Med. 2020 Feb;75(2):162-170.

November 2019

Association of Emergency Clinicians' Assessment of Mortality Risk With Actual 1-Month Mortality Among Older Adults Admitted to the Hospital.

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 Follow‐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
Carpenter CRArendts G, Hullick C , Nagaraj, Cooper Z, Burkett E

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