Falls at the Geriatric Hospital Ward in the Context of Risk Factors of Falling Detected in a Comprehensive Geriatric Assessment

Abstract

It is only by knowing the most common causes of falls in the hospital that appropriate and targeted fall prevention measures can be implemented. This study aimed to assess the frequency of falls in a hospital geriatrics ward and the circumstances in which they occurred and evaluate the parameters of the comprehensive geriatric assessment (CGA) correlating with falls. We considered medical, functional, and nutritional factors associated with falls and built multivariable logistic regression analysis models. A total of 416 (median age 82 (IQR 77–86) years, 77.4% women) hospitalizations in the geriatrics ward were analyzed within 8 months. We compared the results of a CGA (including health, psycho-physical abilities, nutritional status, risk of falls, frailty syndrome, etc.) in patients who fell and did not fall. Fourteen falls (3.3% of patients) were registered; the rate was 4.4 falls per 1000 patient days. They most often occurred in the patient’s room while changing position. Falls happened more frequently among people who were more disabled, had multimorbidity, were taking more medications (certain classes of drugs in particular), had Parkinson’s disease and diabetes, reported falls in the last year, and were diagnosed with orthostatic hypotension. Logistic regression determined the significant independent association between in-hospital falls and a history of falls in the previous 12 months, orthostatic hypotension, Parkinson’s disease, and taking statins, benzodiazepines, and insulin. Analysis of the registered falls that occurred in the hospital ward allowed for an analysis of the circumstances in which they occurred and helped to identify people at high risk of falling in a hospital, which can guide appropriate intervention and act as an indicator of good hospital care.

Identificando medicações potencialmente inapropriadas em pacientes idosos em ambulatório de Geriatria do Distrito Federal utilizando os Critérios de Beers®

“…As quedas são frequentes em pessoas idosas e tem repercussões sociais e econômicas para os pacientes e suas famílias, visto que podem causar incapacidade, restrição das atividades de vida diária, medo de novas quedas, reduzindo a qualidade de vida e independência desses pacientes (12). De acordo com um estudo polonês, quais 45% dos indivíduos com idade superior há 75 anos relataram pelo menos uma queda no período de 1 ano (18), achado corroborado no presente estudo.…”

Analysis of the incidence of falls and related factors in elderly patients based on comprehensive geriatric assessment

“…The above assessment contents are the most direct clinical reflection of the older patient's comprehensive health, which are also mostly concerned by clinical workers. Relevant studies confirmed that CGA showed good results in fall screening and benefits in making comprehensive intervention plan according to prevent falls in the hospital 10,11 . Thus, CGA is an effective method from multiple perspectives in fall screening 12 …”

“…Relevant studies confirmed that CGA showed good results in fall screening and benefits in making comprehensive intervention plan according to prevent falls in the hospital. 10,11 Thus, CGA is an effective method from multiple perspectives in fall screening. 12 The goal of the present study was to evaluate the fall status of elderly patients in outpatient and inpatient departments of geriatrics by CGA and to analyze its related factors.…”

“…CGA is a welcome trend and a hot topic in geriatric medicine all over the world. It has clear advantages in preventing falls in older people 10,11. Through long-term follow-up CGA, collaboration and ongoing follow-up management by a multidisciplinary team ensure comprehensive continuous assessment and regular flexible adjustment of interventions.…”

Mortality Trends due to Falls in the Group of People in Early (65–74 Years) and Late (75+) Old Age in Poland in the Years 2000–2020

“…Risk factors of falls, according to the simplest classification, can be divided into intrinsic and extrinsic [ 8 ]. The first group includes nonmodifiable factors, such as age and gender and health-related factors, while the other group includes environmental factors such as home surroundings, government policy on environmental design, housing standards, public transport, neighborhood conditions, and social networks [ 9 ]. In the elderly population, an accumulation of risk factors can be observed in both groups.…”