The relationship of falls to injury among hospital in-patients

Abstract

The need to reduce falls is driven by the need to reduce injury. If patients at risk of injury can be distinguished from the patients at risk of falls, there is the potential for a more effective fall risk management policy by targeting injury prevention measures. We conducted a prospective observational study, with blinded endpoint evaluation of 825 consecutive patients admitted to geriatric rehabilitation wards. We identified 150 fallers (18.2%) contributing 243 falls. Fifty-six patients sustained an injury contributing 73 (30.0%) injurious falls. Only five (6.8%) falls resulted in injury of major severity. We identified no significant differences in demographics between injurious and non-injurious falls. A logistic regression analyses of the independent risk factors of suffering an injurious fall were a history of falls (p=0.036), confusion (p=0.001) and an unsafe gait (p=0.03). However, we identified no significant differences in clinical characteristics between patients suffering injurious and non-injurious falls. None of the characteristics studied can identify patients prone to injury after a fall. Injury is largely unpredictable, and more research is needed to determine how injury can be prevented in patients at risk of falls.

Predictors of serious injury among hospitalized patients evaluated for falls

“…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. 2,3,17,18 In this study, inpatient falls were associated with an almost 2-week increase in length of stay. Though we cannot say that this was directly due to falls, and an increased length of stay may just be a marker of severity of illness, this association warrants further study, perhaps with a matched control group of patients who did not fall, and has implications for healthcare cost containment.…”

Circumstances of Patient Falls and Injuries In 9 Hospitals In a Midwestern Healthcare System

“…Furthermore, even if fall rates remain the same, increasing the proportion of falls that are assisted by a staff member could help decrease injury rates and injury severity. Confusion or altered cognition has been documented as a risk factor for fall-related injuries in elderly people living in a community, 13 nursing home residents, [16][17][18] rehabilitation hospital patients, 23,25 and tertiary care hospital patients. 3 However, in our study, altered mental status was associated with a decreased risk of fall-related injury.…”

Gait variability while dual-tasking: fall predictor in older inpatients?

“…Falls in older inpatients occur commonly, and often lead to a cascade of problems such as fractures and other injuries (1,2), prolonged hospital stays (3), feelings of guilt among staff, and litigation (4). Several fall prevention programs have been shown to decrease the fall incidence in geriatric hospitals (5).…”