Risk factors associated with in-hospital falls reported to the Patient Safety Commitee of a teaching hospital

Abstract

Objective To investigate the use of fall-risk-increasing drugs among patients with falls reported to the Patient Safety Office of a hospital, and to identify the factors associated with high risk for fall.Methods A cross-sectional study, carried out in a teaching hospital. The study population was the universe of fall reports received by the Patient Safety Office. The dependent variable was a high risk for falls. The Medication Fall Risk Score was used to measure fall risk. Descriptive, univariate and multivariate analyses were performed.Results Of the 125 fall reports in the study, 38 (30.4%) were in 2014, 26 (20.8%) in 2015, and 61 (48.8%) in 2016. Half of the patients (63; 50.4%) were classified as high fall risk and 74 (59.2%) had two or more risk factors for the event. The most frequently used drug classes were opioids (25%), anxiolytics (19.7%), beta-blockers (9.9%), angiotensin II antagonists (7%) and vascular-selective calcium channel blockers (7%). After the adjusted analysis, the factors associated with falls were amputation (odds ratio: 14.17), female sex (odds ratio: 2.98) and severe pain (odds ratio: 5.47).Conclusion Medications are an important contributor to in-hospital falls, and the Medication Fall Risk Score can help identify patients at a high risk for falls.

Caracterização dos episódios de queda em uma unidade de cardiologia: estudo retrospectivo

“…Estudos demonstram que síndromes geriátricas são bastante prevalentes em indivíduos hospitalizados e, dessa forma, tornam-se um fator importante a ser considerado na predição do risco de queda (9)(10)(22)(23)(24) . A faixa etária da população, deste estudo, evidencia o predomínio de pacientes idosos, em consonância com dados globais.…”

“…A terapia medicamentosa é um aspecto importante a ser considerado, uma vez que estes podem potencializar os riscos para a ocorrência de quedas, por promover efeitos adversos como desequilíbrio postural, fraqueza muscular, hipotensão, confusão mental e delirium (11,20,25,30) . Dentre os medicamentos potencializadores para o risco de quedas, pode-se citar os medicamentos que atuam no sistema nervoso central e aqueles que atuam no sistema cardiovascular como: hipnóticos, antipsicóticos, ansiolíticos, benzodiazepínicos, opioides, barbitúricos, antihistamínico, anticonvulsivantes, sedativos, antidepressivos, laxantes, anti-hipertensivos e diuréticos (9,20,25) . Sousa AL, Monteiro AC, Ambiel MLBR, et al Revista de Enfermagem do Centro-Oeste Mineiro 2020; 10/4059 www.ufsj.edu.br/recom -6…”

“…A ANVISA reportou em um relatório sobre assistência hospitalar, que 38,2% dos eventos adversos correspondem às quedas (5) . A queda é conceituada como um deslocamento não intencional do corpo para um nível inferior à posição inicial, decorre de circunstâncias multifatoriais que comprometem a estabilidade e a manutenção do bem-estar do indivíduo (9) . É um incidente complexo, não intencional, traumático e multifatorial que pode ser causado por diversos fatores, sejam eles intrínsecos ou extrínsecos (10)(11)(12) .…”

Factors associated with risk, perception and knowledge of falls in elderly people

“…In 2014, falls were the third most reported adverse event in hospitals in Brazil. The main victims of falls in-hospitals are older adults, who are affected by the changes associated with senescence and senility, the increase in chronic diseases, the consequent use of multiple medications and the presence of pain (7) .…”

Comparison of medication-related fall risk in hospitalized adults and older people

“…Fall is widely known for the potential damage deriving from its occurrence, and it is one of the most notified incidents during hospitalization (National Academies of Sciences, 2018). The older population were identified as the individuals who mostly experience falls inside the hospital environment (Silva et al, 2019). In Brazil, falls were the fourth most frequently notified safety incident between August 2019 and July 2020 and the third incident resulting in death (Agência Nacional de Vigilância Sanitária, 2019).…”