Characteristics of Single Fallers and Recurrent Fallers among Hospital In-Patients

Abstract

Background: Recurrent fallers constitute a minority of patients who fall but contribute considerably to the total number of falls recorded. Objective: To study the characteristics of recurrent fallers in a hospital setting. Methods: In a prospective observational study we investigated the characteristics of 1,025 patients admitted to a geriatric non-acute hospital. Patients were followed until discharge and were classified as non-fallers, single fallers or recurrent fallers. Results: We identified 824 non-fallers, 136 single fallers and 65 recurrent fallers contributing 175 falls. Compared to non-fallers, recurrent fallers were more likely to have pre-admission falls (p = 0.004), confusion (p < 0.0001), an unsafe gait (p = 0.0001) and be on tranquillisers (p = 0.018) and antidepressants (p = 0.006). They had longer stays in hospital (p < 0.0001) and more nursing home discharges (p = 0.0001). There was considerable overlap with risk factors for single fallers but compared to this group they were more likely to be confused (p = 0.027), and on antidepressant medication (p = 0.009). They also had a longer length of stay (p < 0.001) and more nursing home discharges (p = 0.03). Confusion (p = 0.0001), unsafe gait (p = 0.0006) and antidepressants (p = 0.018) were independently associated with recurrent falls. Conclusions: It is important to recognise the risk factors that prospectively identify a recurrent faller because of the significant contribution to total falls by a relatively small number of patients. This may be useful not only in trying to reduce total falls but also in trying to reduce injury.

Predictors of falls and hospitalization outcomes in elderly patients admitted to an acute geriatric unit

“…Similarly to previous investigations fallers presented a prolonged LOS and a greater prevalence of nursing home placement after hospital discharge, with a worsened quality of life for the patients and an increased health care cost burden (Vassallo et al, 2002).…”

Development of an assessment sheet for fall prediction in stroke inpatients in convalescent rehabilitation wards in Japan

“…Among 270 fallers 46% of them were recurrent fallers. It has been indicated that recurrent fallers might show poor improvement of BI or ADL compared to single and nonfallers [28,29]. However, we attached importance to the first fall to be involved in the present assessment sheet because, as our results clarified, many falls occurred within a short time after admission and because the previous report revealed that fallers might develop a psychological change such as fear of falling resulting in self-induced restrictions in activity [16,17].…”

Cognitive Impairment Is the Major Risk Factor for Development of Geriatric Syndromes during Hospitalization: Results from the GIFA Study

“…These results are in agreement with previous studies that found that the rate of incidence of subsequent falls increased with the number of falls in community-dwelling [16] and hospitalized elderly subjects [17] . Although the risk factors for multiple fallers can be slightly different from one-time fallers [18] , in hospitalized population a signifi cant role seems to be played by the use of CNS active drugs [19] . Our study confi rms these reports, as we found a signifi cant increased risk of falls in subjects treated with neuroleptics and benzodiazepines.…”