Risk Factors for Falls in Tertiary Hospital Inpatients: A Survival Analysis

Abstract

The purpose of this study was to identify the risk factors for falls in tertiary hospital inpatients and to suggest data for developing a nursing intervention program for preventing falls. Methods: Data were collected between January 1, 2017, to December 31, 2017. Kaplan-Meier estimation was used to measure the survival rate, and the log-rank test was used for the differences between the fall group and the non-fall group. The Cox proportional hazards model was used to identify the risk factors for falls. Results: The incidence rate of falls for the inpatients was 1.2 cases per 1,000 days of hospitalization. The risk factors for falls were more likely to be found among those who were aged ≥81, had not undergone surgery, had poor joint motion, had unsteady gait, needed help or supervision, used assistive devices, had comorbidity, and took at least two drugs. Conclusion: For the inpatients, the risk factors for falls included age, surgery, comorbidity, medication that could change mobility, joint motion, and use of patient care equipment. It is necessary to give special attention to inpatients who have any of these risk factors and to develop a falls risk assessment tool.

Falls in Patients of Medical Institutions in South Korea: A Literature Review

“…In general, 38%-66% of falls occurred in impatient rooms [10][11][12][13][14][15][16][17][18]. Whereas, 57% of falls in patients with dementia in nursing hospitals occurred in lobbies and corridors [19].…”

“…36%-55% of activities during falls accounted for ambulation [11,16,18,19]. Causes of falls included loss of balance, tripping, and dizziness, and the loss of balance was the most common cause [11,14,18,19]. The medical department in which falling accidents were commonly reported was the internal medicine [10,11,13,20], and most patients were in a clear state of consciousness [11,[16][17][18].…”

“…Risk factors of falls included age, medical departments that patients were admitted, urination disorder, unstable gait, gender, history of falling, orientation, fear of falling, and use of assistive devices [10][11][12][13][14][16][17][18][19][20][21][22][23][24][25][26][27][28][29]. The fall risk also depended on medications, and the fall risk increased by 5-, 6-and 7-folds with use of diuretics, antihistamines, and zolpidem, respectively [19,22].…”

“…Fall incidence and fall risk factor 20 Ahn and Kim [13]; Cho and Lee [24]; Cho and Lee [11]; Cho et al [14]; Choi et al [10]; Hong et al [25]; Hwang and Jung [26]; Jang and Lee [12]; Jeong et al [23]; Kang and Song [20]; Kim et al [21]; Kim and Lee [16]; Kim and Lee [27]; Lee and Yoon [18]; Lee and Kim [28]; Lee [22]; Lee and Gu [15]; Lee et al [ Chang et al [58]; Cho and Jang [60]; Jang and Kim [49]; Jeong and Park [52]; Jin and Ha [53]; Jung and Jung [50]; Jung et al [48]; Jung [64]; Jung and Kim [63]; Kim [59]; Kim and Seo [54]; Lee and Choi [47]; Lim and Gu [55]; Park and Son [56]; Park and Han [46]; Park [61]; Park and Yun [62]; Yoo…”

Trends of Nursing Research on Accidental Falls: A Topic Modeling Analysis

“…The incidence of patient falls varies among countries and medical institutions. In the United States, 3.3–11.5 falls are observed per 1000 hospitalization days, while in South Korea 400–700 falls annually have been reported [ 4 , 5 , 6 , 7 , 8 , 9 ]. Falls often have negative consequences, including physical injuries such as bleeding and fractures, psychological damage such as anxiety, fear, and loss of independence, and even death [ 10 , 11 , 12 ].…”