Risk of falls for hospitalized patients A predictive model based on routinely available data

Halfon, Patricia; Eggli, Yves; Melle, Guy van; Vagnair, André

doi:10.1016/s0895-4356(01)00406-1

Cited by 169 publications

(153 citation statements)

References 38 publications

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“…Our study confirms that a high percentage of patients with an initial fall will have recurrent falls. 1 Additionally, the majority of patients in this cohort fell despite having been assessed as ''at risk for falling'' prior to the event. The types of injuries sustained after inpatient falls (eg, subdural hematoma, multiple fractures, joint effusions, other hematomas, and soft-tissue swelling) are similar to those found by other authors.…”

Section: Discussionmentioning

confidence: 96%

“…21 However, previous studies have found no indication that falls are underreported and suggest that incident reports are an established custom in hospital culture. 1,22 Medical staff are aware that administrators want to keep track of hospital fall rates for both quality improvement and documentation for risk management. 1,22 It is unlikely that severe falls or falls leading to serious injury are not reported.…”

Section: Discussionmentioning

confidence: 99%

Section: Abstract: Fall Prevention Injury Inpatient Fallsmentioning

confidence: 99%

“…1 Approximately 30% of such falls result in injury and up to 6% may be serious in nature. 1,2 These injuries can result in pain, functional impairment, disability, or even death, and can contribute to longer lengths of stay, increased health care costs, and nursing home placement. [2][3][4][5] As a result, inpatient falls have become a major priority for hospital quality assurance programs, and hospital risk management departments have begun to target inpatient falls as a source of legal liability.…”

Section: Abstract: Fall Prevention Injury Inpatient Fallsmentioning

confidence: 99%

“…[2][3][4][5] As a result, inpatient falls have become a major priority for hospital quality assurance programs, and hospital risk management departments have begun to target inpatient falls as a source of legal liability. [1][2][3]6,7 Recently, the Centers for Medicare and Medicaid Services announced that it will no longer pay for preventable complications of hospitalizations, including falls and fallrelated injury. 8 Much of the literature on falls comes from community and long-term care settings, and only a few studies have investigated falls during acute care hospitalization.…”

Section: Abstract: Fall Prevention Injury Inpatient Fallsmentioning

confidence: 99%

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Predictors of serious injury among hospitalized patients evaluated for falls

Bradley

Karani

McGinn

et al. 2010

Journal of Hospital Medicine

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BACKGROUND:Inpatient falls are common and result in significant patient morbidity.OBJECTIVE:To identify predictors of serious injury being found on imaging studies of inpatients evaluated after a fall.DESIGN:Retrospective study.SETTING:An 1171‐bed urban academic medical center.PATIENTS:All inpatients who fell on thirteen medical and surgical units from January 1 to December 31, 2006.MEASUREMENTS:Patient characteristics, circumstances surrounding falls, fall‐related injuries, and length of stay were collected through review of incident reports and computerized medical records. Primary outcome of fall‐related injury was determined by evidence of injury on imaging studies within two weeks of the fall. Univariate and multivariate logistic regression were used to calculate adjusted odds ratios (ORs) for injury after an inpatient fall.RESULTS:A total of 513 patients had 636 falls during the study time period. Fall incidence rate was 1.97 falls per 1,000 patient days. 95 patients (19%) fell multiple times (range, 2‐6 events); 74% of the falls occurred in patients who were previously assessed as being “at risk” by the nursing staff. Multivariate analysis, adjusting for age and sex, found evidence of trauma after a fall (OR = 24.6, P < 0.001) and ambulatory status (OR = 7.3, P < 0.01) to be independent predictors of injury being found on imaging studies.CONCLUSIONS:Inpatient falls are common despite high‐risk patients being identified. After adjusting for age and sex, evidence of trauma and ambulatory status were independent predictors of an injury being found on imaging studies after an inpatient fall. Journal of Hospital Medicine 2010;5:63–68. © 2010 Society of Hospital Medicine.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Section: Abstract: Fall Prevention Injury Inpatient Fallsmentioning

confidence: 99%

Section: Abstract: Fall Prevention Injury Inpatient Fallsmentioning

confidence: 99%

Section: Abstract: Fall Prevention Injury Inpatient Fallsmentioning

confidence: 99%

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Predictors of serious injury among hospitalized patients evaluated for falls

Bradley

Karani

McGinn

et al. 2010

Journal of Hospital Medicine

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Discriminating High Fall Risk on an Inpatient Rehabilitation Unit

Gilewski

Roberts

Hirata

et al. 2007

Rehabilitation Nursing

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The objective of this study was to identify on admission the most discriminating fall predictors for patients to an inpatient rehabilitation unit. Medical information from 34 patients who fell over a consecutive 7-month period and 102 controls (1:3 ratio) matched for diagnosis, age, and gender was analyzed to identify a set of best predictors. Admission mobility and problem solving FIM scores accounted for 17% of variance in whether a fall occurred during the admission. After statistically deriving optimal cutoff thresholds for decision making, high fall risk was retroactively assigned to patients. Logistic regression revealed increased odds of having fallen by 5.1 times for poorer mobility and 2.4 times for poorer problem solving. The practical benefits of the evidence-based risk assessment were discussed.

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A Time Series Analysis of Falls and Injury in the Inpatient Rehabilitation Setting

Frisina

Guellnitz

Alverzo

2010

Rehabilitation Nursing

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The purpose of this study is to assess whether falls and injuries are influenced by a temporal pattern (defined as a pattern based on the time of day) in the inpatient acute rehabilitation unit/hospital (IRU/H) setting. A retrospective chart review and analysis of falls and injuries among inpatients admitted to our facility during a 9-month period was performed. The sample consisted of 367 patients who had fallen at least once; 71 had repeated falls, bringing the total number of falls to 438. Significant variation in the prevalence of falls (chi2 = 24.1, p <. 01) and injuries (chi2 = 12.90, p < .01) based on time of day and shift was observed. In addition, a temporal pattern of fall-related injuries with patients who had sustained stroke and brain injury (chi2 = 12.74, p = .045) was also observed. The findings from this study allow for the development of interventions that are appropriate when falls and injury are most prevalent for different clinical populations in the IRU/H setting.

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Risk of falls for hospitalized patients A predictive model based on routinely available data

Cited by 169 publications

References 38 publications

Predictors of serious injury among hospitalized patients evaluated for falls

Predictors of serious injury among hospitalized patients evaluated for falls

Discriminating High Fall Risk on an Inpatient Rehabilitation Unit

A Time Series Analysis of Falls and Injury in the Inpatient Rehabilitation Setting

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