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Patterns and Predictors of Inpatient Falls and Fall-Related Injuries in a Large Academic Hospital

Published online by Cambridge University Press:  21 June 2016

Irene D. Fischer ,
Melissa J. Krauss ,
William Claiborne Dunagan ,
Stanley Birge ,
Eileen Hitcho ,
Shirley Johnson ,
Eileen Costantinou  and
Victoria J. Fraser
Irene D. Fischer
Affiliation:
Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
Melissa J. Krauss
Affiliation:
Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
William Claiborne Dunagan
Affiliation:
Department of Medicine, Washington University School of Medicine, St. Louis, Missouri BJC Health Care, St. Louis, Missouri
Stanley Birge
Affiliation:
Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
Eileen Hitcho
Affiliation:
Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
Shirley Johnson
Affiliation:
Barnes-Jewish Hospital, St. Louis, Missouri
Eileen Costantinou
Affiliation:
Barnes-Jewish Hospital, St. Louis, Missouri
Victoria J. Fraser*
Affiliation:
Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
*
Department of Internal Medicine, Washington University School of Medicine, Campus Box 8051, 660 South Euclid Avenue, St. Louis, MO 63110vfraser@im.wustl.edu
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Abstract

Objectives:

Most research on hospital falls has focused on predictors of falling, whereas less is known about predictors of serious fall-related injury. Our objectives were to characterize inpatients who fall and to determine predictors of serious fall-related injury.

Methods:

We performed a retrospective observational study of 1,082 patients who fell (1,235 falls) during January 2001 to June 2002 at an urban academic hospital. Multivariate analysis of potential risk factors for serious fall-related injury (vs no or minor injury) included in the hospital's adverse event reporting database was conducted with logistic regression to calculate adjusted odds ratios (aORs) with 95% confidence intervals (CI95).

Results:

The median age of patients who fell was 62 years (interquartile range, 49-77 years), 50% were women, and 20% were confused. The hospital fall rate was 3.1 falls per 1,000 patient-days, which varied by service from 0.86 (women and infants) to 6.36 (oncology). Some (6.1%) of the falls resulted in serious injury, ranging by service from 3.1% (women and infants) to 10.9% (psychiatry). The most common serious fall-related injuries were bleeding or laceration (53.6%), fracture or dislocation (15.9%), and hematoma or contusion (13%). Patients 75 years or older (aOR, 3.2; CI95, 1.3-8.1) and those on the geriatric psychiatry floor (aOR, 2.8; CI95,1.3-6.0) were more likely to sustain serious fall-related injuries.

Conclusions:

There is considerable variation in fall rates and fall-related injury percentages by service. More detailed studies should be conducted by floor or service to identify predictors of serious fall-related injury so that targeted interventions can be developed to reduce them.

Type
Orginal Articles
Information
Infection Control & Hospital Epidemiology , Volume 26 , Issue 10 , October 2005 , pp. 822 - 827
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2005

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