Falls following discharge after an in-hospital fall

被引：28

作者：

Davenport R.D. ^{[1
]}

Vaidean G.D. ^{[2
]}

Jones C.B. ^{[3
]}

Chandler A.M. ^{[3
]}

Kessler L.A. ^{[3
]}

Mion L.C. ^{[4
]}

Shorr R.I. ^{[5
,6
]}

机构：

[1] HSRandD/RRandD Center of Excellence, James A. Haley VAMC, Tampa, FL 33637

[2] Department of Pharmacy and Health Outcomes, Touro College of Pharmacy, New York, NY 10027

[3] Methodist Healthcare Foundation, Memphis, TN 38104

[4] School of Nursing, Vanderbilt University, Nashville, TN 37240

[5] Geriatric Research Education, and Clinical Center (GRECC), Malcom Randall VAMC (182), Gainesville, FL 32608

[6] Department of Aging and Geriatric Research, University of Florida, Gainesville, FL 32611

来源：

BMC Geriatrics | / 9卷 / 1期

关键词：

Fall Prevention; Fall Rate; Skilled Nursing Facility; Nursing Home Placement; Weekly Phone Call;

D O I：

10.1186/1471-2318-9-53

中图分类号：

学科分类号：

摘要：

Background. Falls are among the most common adverse events reported in hospitalized patients. While there is a growing body of literature on fall prevention in the hospital, the data examining the fall rate and risk factors for falls in the immediate post-hospitalization period has not been well described. The objectives of the present study were to determine the fall rate of in-hospital fallers at home and to explore the risk factors for falls during the immediate post-hospitalization period. Methods. We identified patients who sustained a fall on one of 16 medical/surgical nursing units during an inpatient admission to an urban community teaching hospital. After discharge, falls were ascertained using weekly telephone surveillance for 4 weeks post-discharge. Patients were followed until death, loss to follow up or end of study (four weeks). Time spent rehospitalized or institutionalized was censored in rate calculations. Results. Of 95 hospitalized patients who fell during recruitment, 65 (68%) met inclusion criteria and agreed to participate. These subjects contributed 1498 person-days to the study (mean duration of follow-up = 23 days). Seventy-five percent were African-American and 43% were women. Sixteen patients (25%) had multiple falls during hospitalization and 23 patients (35%) suffered a fall-related injury during hospitalization. Nineteen patients (29%) experienced 38 falls at their homes, yielding a fall rate of 25.4/1,000 person-days (95% CI: 17.3-33.4). Twenty-three patients (35%) were readmitted and 3(5%) died. One patient experienced a hip fracture. In exploratory univariate analysis, persons who were likely to fall at home were those who sustained multiple falls in the hospital (p = 0.008). Conclusion. Patients who fall during hospitalization, especially on more than one occasion, are at high risk for falling at home following hospital discharge. Interventions to reduce falls would be appropriate to test in this high-risk population. © 2009 Davenport et al; licensee BioMed Central Ltd.

引用

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