School of Physiotherapy and Institute for Health and Rehabilitation Research, The University of Notre Dame Australia, Fremantle, Western Australia, Australia.
Aust Crit Care. 2011 Aug;24(3):167-74. doi: 10.1016/j.aucc.2011.06.001. Epub 2011 Jul 23.
Falling among adults in acute care is an important problem with falls rates in tertiary hospitals ranging from 2% to 5%. Factors that increase the risk of falling, such as advanced age, altered mental status, medications that act on the central nervous system and poor mobility, often characterise individuals who survive a prolonged intensive care unit (ICU) admission.
To measure the incidence of falls and describe the characteristics of fallers among intensive care survivors.
A comprehensive retrospective chart review was undertaken of 190 adults who were intubated and ventilated for ≥ 168 h and survived their acute care stay. Using a standardised form, several variables were extracted including falls during hospitalisation and risk factors such as age, severity of illness, and length of stay in intensive care and hospital.
Thirty-two (17%, 95% confidence interval 11.5-22.2%) patients fell at least once on the in-patient wards following their ICU stay. Compared with non-fallers, fallers were younger (53.2 ± 17.9 vs. 44.1 ± 18.3 years; p=0.009) and had a shorter duration of inotropic support in ICU (84 ± 112 vs. 56 ± 100 h; p=0.040). The majority of fallers were aged less than 65 years (84%). Both fallers and non-fallers had similar APACHE II scores (20 ± 8 vs. 21 ± 7; p=0.673), length of stay in intensive care (14.2 ± 8.7 vs. 14.0 ± 9.7 days; p=0.667) and hospital length of stay (43.9 ± 33.1 vs. 41.0 ± 38.8 days; p=0.533).
Falling during hospitalisation is common in intensive care survivors. Compared with non-fallers, fallers were younger and required inotropes for a shorter duration. Those who survive a prolonged admission to an ICU may benefit from specific assessment of balance and falls risk by the multidisciplinary team.
成人在急性护理中跌倒发生率较高，三级医院的跌倒发生率在 2%至 5%之间。增加跌倒风险的因素，如年龄较大、精神状态改变、作用于中枢神经系统的药物以及活动能力较差，这些因素通常是在重症监护病房（ICU）入住时间延长的个体的特征。
测量跌倒发生率并描述 ICU 幸存者中跌倒者的特征。
对 190 名接受气管插管和通气时间≥168 小时并存活急性护理期的成年人进行了全面的回顾性图表审查。使用标准化表格提取了包括住院期间跌倒以及年龄、疾病严重程度和 ICU 及医院住院时间等危险因素在内的几个变量。
32 名（17%，95%置信区间 11.5-22.2%）患者在 ICU 后入住住院病房时至少跌倒一次。与非跌倒者相比，跌倒者年龄较小（53.2 ± 17.9 岁 vs. 44.1 ± 18.3 岁；p=0.009），ICU 中使用正性肌力药物的时间较短（84 ± 112 小时 vs. 56 ± 100 小时；p=0.040）。大多数跌倒者年龄小于 65 岁（84%）。跌倒者和非跌倒者的急性生理与慢性健康评分（APACHE II）相似（20 ± 8 分 vs. 21 ± 7 分；p=0.673），ICU 住院时间（14.2 ± 8.7 天 vs. 14.0 ± 9.7 天；p=0.667）和医院住院时间（43.9 ± 33.1 天 vs. 41.0 ± 38.8 天；p=0.533）。
住院期间跌倒在 ICU 幸存者中很常见。与非跌倒者相比，跌倒者年龄较小，使用正性肌力药物的时间较短。那些 ICU 入住时间延长的患者可能受益于多学科团队对平衡和跌倒风险的具体评估。
