Brown Carlos V R, Ali Sadia, Fairley Romeo, Lai Bryan K, Arthrell Justin, Walker Melinda, Tips Gaylen
Department of Surgery, Trauma Services, University Medical Center Brackenridge, Austin, TX 78701, USA.
Am Surg. 2013 May;79(5):465-9.
Inpatient falls lead to an injury in 30 per cent of cases and serious injury in 5 per cent. Increasing staffing and implementing fall prevention programs can be expensive and require a significant use of resources. We hypothesized that trauma patients have unique risk factors to sustain a fall while hospitalized. This is a retrospective cohort study from 2005 to 2010 of all trauma patients admitted to an urban Level I trauma center. Patients who fell while hospitalized were compared with patients who did not fall to identify risk factors for sustaining an inpatient fall. There were 16,540 trauma patients admitted during the study period and 128 (0.8%) fell while hospitalized. Independent risk factors for a trauma patient to fall while hospitalized included older age (odds ratio [OR], 1.02 [1.01 to 1.03], P < 0.001), male gender (OR, 1.6 [1.0 to 2.4], P = 0.03), blunt mechanism (OR, 5.1 [1.6 to 16.3], P = 0.006), Glasgow Coma Score at admission (OR, 0.59 [0.35 to 0.97], P = 0.04), intensive care unit admission (OR, 2.3 [1.4 to 3.7], P = 0.001), and need for mechanical ventilation (OR, 2.2 [1.2 to 3.9], P = 0.01). Trauma patients who fell while hospitalized sustained an injury in 17 per cent of cases and a serious injury in 5 per cent. Inpatient falls in hospitalized trauma patients are uncommon. Risk factors include older age, male gender, blunt mechanism, lower Glasgow Coma Score, and the need for intensive care unit admission or mechanical ventilation. Trauma patients with these risk factors may require higher staffing ratios and should be enrolled in a formal fall prevention program.
住院患者跌倒在30%的病例中会导致受伤，5%会导致重伤。增加医护人员配备和实施预防跌倒计划成本高昂，且需要大量资源。我们推测创伤患者在住院期间有导致跌倒的独特风险因素。这是一项对2005年至2010年入住城市一级创伤中心的所有创伤患者进行的回顾性队列研究。将住院期间跌倒的患者与未跌倒的患者进行比较，以确定住院患者跌倒的风险因素。研究期间共收治16540例创伤患者，其中128例（0.8%）在住院期间跌倒。创伤患者住院期间跌倒的独立风险因素包括年龄较大（比值比[OR]，1.02[1.01至1.03]，P<0.001）、男性（OR，1.6[1.0至2.4]，P = 0.03）、钝器伤机制（OR，5.1[1.6至16.3]，P = 0.006）、入院时格拉斯哥昏迷评分（OR，0.59[0.35至0.97]，P = 0.04）、入住重症监护病房（OR，2.3[1.4至3.7]，P = 0.001）以及需要机械通气（OR，2.2[1.2至3.9]，P = 0.01）。住院期间跌倒的创伤患者在17%的病例中受伤，5%为重伤。住院创伤患者的住院跌倒并不常见。风险因素包括年龄较大、男性、钝器伤机制、格拉斯哥昏迷评分较低以及需要入住重症监护病房或进行机械通气。有这些风险因素的创伤患者可能需要更高的医护人员配比，应纳入正式的预防跌倒计划。
