Literature DB >> 23002493

Is it possible to identify risks for injurious falls in hospitalized patients?

Lorraine C Mion1, A Michelle Chandler, Teresa M Waters, Mary S Dietrich, Lori A Kessler, Stephen T Miller, Ronald I Shorr.   

Abstract

BACKGROUND: Patient falls are among the most commonly reported adverse hospital events with more than one million occurring annually in the United States; approximately 10% result in serious injury. A retrospective study was conducted to determine predictors and outcomes of fall injuries among a cohort of adult hospitalized patients.
METHODS: Data were obtained regarding patients who sustained an initial fall in hospital during a 26-month period from 16 adult general medical and surgical units in an urban university-affiliated community hospital. Data on intrinsic (individual) factors, extrinsic (environmental) factors, and situational activities were collected via nurse and patient interviews, patient examinations, and audits of incident reports and electronic health records. Fall injuries were classified as none/any for analyses. Unadjusted odds ratios [ORs] and 95% confidence intervals [CIs] for each of the variables of interest with fall injury were generated using logistic regressions.
RESULTS: The 784 patients had a median age of 63.5 years (range, 20 to > 90 years), 390 (50%) were women, and 526 (67%) were black. Some 228 (29%) fallers sustained injury; patients who were white (OR: 2.23; 95% CI: 1.62, 3.08), or were administered a selective serotonin reuptake inhibitor (OR: 1.04; 95% CI: 1.04, 2.67), two antipsychotic agents (OR: 3.26; 95% CI: 1.20, 8.90), an opiate (OR: 1.59; 95%; CI: 1.14, 2.20), or a diuretic non-antihypertensive agent (OR: 1.53; 95% CI: 1.03, 2.26) were more likely to sustain an injury. Home-based wheelchair use was protective of fall injury (OR: 0.20; 95% CI: 0.05, 0.84). Seventy-nine percent of the patients had been designated as "high" fall risk within 24 hours before the fall.
CONCLUSIONS: Few variables were able to distinguish patients who sustained injury after a hospital fall, further challenging clinicians' efforts to minimize hospital-related fall injury.

Entities:  

Mesh:

Year:  2012        PMID: 23002493      PMCID: PMC3547233          DOI: 10.1016/s1553-7250(12)38052-5

Source DB:  PubMed          Journal:  Jt Comm J Qual Patient Saf        ISSN: 1553-7250


  42 in total

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2.  The relationship of the hospital-acquired injurious fall rates with the quality profile of a hospital's care delivery and nursing staff patterns.

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Journal:  Nurs Econ       Date:  2011 Nov-Dec       Impact factor: 1.085

Review 3.  American Geriatrics Society updated Beers Criteria for potentially inappropriate medication use in older adults.

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Journal:  J Am Geriatr Soc       Date:  2012-02-29       Impact factor: 5.562

Review 4.  Fall prevention in the elderly: analysis and comprehensive review of methods used in the hospital and in the home.

Authors:  Terry A Clyburn; John A Heydemann
Journal:  J Am Acad Orthop Surg       Date:  2011-07       Impact factor: 3.020

5.  The cost of serious fall-related injuries at three Midwestern hospitals.

Authors:  Catherine A Wong; Angela J Recktenwald; Marilyn L Jones; Brian M Waterman; Mara L Bollini; Wm Claiborne Dunagan
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6.  A 10-year cohort study of the burden and risk of in-hospital falls and fractures using routinely collected hospital data.

Authors:  C A Brand; V Sundararajan
Journal:  Qual Saf Health Care       Date:  2010-06-17

7.  Unraveling the association between SSRI use and falls: an experimental study of risk factors for accidental falls in long-term paroxetine users.

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8.  Outcomes following physical restraint reduction programs in two acute care hospitals.

Authors:  L C Mion; J Fogel; S Sandhu; R M Palmer; A F Minnick; T Cranston; F Bethoux; C Merkel; C S Berkman; R Leipzig
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9.  Characteristics and circumstances of falls in a hospital setting: a prospective analysis.

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Review 10.  Risk factors and risk assessment tools for falls in hospital in-patients: a systematic review.

Authors:  David Oliver; Fergus Daly; Finbarr C Martin; Marion E T McMurdo
Journal:  Age Ageing       Date:  2004-03       Impact factor: 10.668

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  12 in total

1.  In-Hospital Sequelae of Injurious Falls in 24 Medical/Surgical Units in Four Hospitals in the United States.

Authors:  Anne-Marie Hill; Angela Jacques; A Michelle Chandler; Phyllis A Richey; Lorraine C Mion; Ronald I Shorr
Journal:  Jt Comm J Qual Patient Saf       Date:  2018-09-28

2.  Association Between Characteristics of Injurious Falls and Fall Preventive Interventions in Acute Medical and Surgical Units.

Authors:  Jacqueline Francis-Coad; Anne-Marie Hill; Angela Jacques; A Michelle Chandler; Phyllis A Richey; Lorraine C Mion; Ronald I Shorr
Journal:  J Gerontol A Biol Sci Med Sci       Date:  2020-09-25       Impact factor: 6.053

3.  Developing a Scoring Model to Predict the Risk of Injurious Falls in Elderly Patients: A Retrospective Case-Control Study in Multicenter Acute Hospitals.

Authors:  Min Zhao; Shuguang Li; Yun Xu; Xiaoxia Su; Hong Jiang
Journal:  Clin Interv Aging       Date:  2020-09-24       Impact factor: 4.458

4.  Fall-related admissions after fast-track total hip and knee arthroplasty - cause of concern or consequence of success?

Authors:  Christoffer C Jørgensen; Henrik Kehlet
Journal:  Clin Interv Aging       Date:  2013-11-26       Impact factor: 4.458

5.  Incidence and characteristic analysis of in-hospital falls after anesthesia.

Authors:  Chen-Fuh Lam; Shiu-Ying Hsieh; Jen-Hung Wang; Hui-Shan Pan; Xiu-Zhu Liu; Yu-Ching Ho; Tsung-Ying Chen
Journal:  Perioper Med (Lond)       Date:  2016-05-23

6.  Development of a risk assessment tool to predict fall-related severe injuries occurring in a hospital.

Authors:  Shin-ichi Toyabe
Journal:  Glob J Health Sci       Date:  2014-05-15

7.  Transcultural adaptation of the Johns Hopkins Fall Risk Assessment Tool.

Authors:  Maria Carmen Martinez; Viviane Ernesto Iwamoto; Maria do Rosário Dias de Oliveira Latorre; Adriana Moreira Noronha; Ana Paula de Sousa Oliveira; Carlos Eduardo Alves Cardoso; Ifigenia Augusta Braga Marques; Patrícia Vendramim; Paula Cristina Lopes; Thais Helena Saes de Sant'Ana
Journal:  Rev Lat Am Enfermagem       Date:  2016-08-29

Review 8.  Fall Prediction and Prevention Systems: Recent Trends, Challenges, and Future Research Directions.

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Journal:  Sensors (Basel)       Date:  2017-11-01       Impact factor: 3.576

9.  Identifying protective and risk factors for injurious falls in patients hospitalized for acute care: a retrospective case-control study.

Authors:  Emmanuel Aryee; Spencer L James; Guenola M Hunt; Hilary F Ryder
Journal:  BMC Geriatr       Date:  2017-11-07       Impact factor: 3.921

10.  Patient and system factors associated with unassisted and injurious falls in hospitals: an observational study.

Authors:  Dawn M Venema; Anne M Skinner; Regina Nailon; Deborah Conley; Robin High; Katherine J Jones
Journal:  BMC Geriatr       Date:  2019-12-11       Impact factor: 3.921

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