Association of Longitudinal Mobility Levels in the Hospital and Injurious Inpatient Falls

Abstract

Falls are one of the most common adverse events in hospitals, and patient mobility is a key risk factor. In hospitals risk assessment tools are used to identify patient-centered fall risk factors and guide care plans, but these tools have limitations. To address these issues, we examined daily patient mobility levels prior to injurious falls using the Johns Hopkins Highest Level of Mobility (JH-HLM), which quantifies key patient mobility milestones from low-level to community distances of walking. We aimed to identify longitudinal characteristics of patient mobility prior to a fall to help identify fallers before the event. Conducting a retrospective matched case-control analysis, we compared mobility levels in the days leading up to an injurious fall between fallers and non-fallers. We observed that patients who suffered an injurious fall, on average, spent 28% of their time pre-fall at a low mobility level (JH-HLM levels 1 to 4), compared to non-fallers who spent 19% of their time at a low mobility level (Mean Absolute Difference: 9%; 95% CI 1% to 16%, p = 0.026; Relative Difference: 44%). This suggests that assessing a patient’s mobility levels over time can help identify those at an increased risk for falls and enable hospitals to manage mobility problems more effectively.