Costa-Dias Maria José, Oliveira Alexandre Santos, Martins Teresa, Araújo Fátima, Santos Ana Sofia, Moreira Cristina Nogueira, José Helena
Institute of Health Sciences, Catholic University of Portugal, Lisbon, Portugal.
Nursing School, Porto, Portugal.
Nurse Educ Today. 2014 Feb;34(2):171-6. doi: 10.1016/j.nedt.2013.05.016. Epub 2013 Jun 14.
While the causes of falls in old hospitalized patients are multifactorial, medication has been considered as one of the most significant factors. Given the large impact that this phenomenon has on the lives of the elderly and organizations, it is important to explore such phenomenon in greater depth.
The objective of this study was to explore the association between medication and falls and the recurrent falls (n≥2), and identify medication related risk for fall in hospitalized patients, in a large acute hospital.
Retrospective and quantitative study from June 2008 to December 2010.
The study was conducted in a private hospital for acute patients in Lisbon, Portugal.
The study included a sample of 214 episodes of fall event notifications which occurred in 193 patients.
The current study was conducted through the "face to face consensus" technique which emerged the treatment groups to investigate. Regarding the data analysis we used Student's t test, ANOVA and Odds Ratio. In the violation of the premises for the use of parametric statistics we used the Kruskal-Wallis test. To assess the fall risk, and the medication-related fall risk, we used the Morse Fall Risk Scale, and the Medication Fall Risk Score.
Patients who received drugs from the therapy group of "Central Nervous System", are 10 times more likely to have fall risk (OR 9. 90, 95% CI 1.6-60.63). Association was found between falls (OR 6.09, 95% CI 1.30-28.54) and its recurrence (OR 3.32, 95% CI 1.61-6.85), among patients receiving haloperidol and receiving tramadol for recurrent falls (OR 3.10, 95% CI 1.59-6.07). In 34% of the patients the medication fall risk score was 6 or higher.
This current study allowed identifying medication-related risk factors for falls, that nurses should consider when prescribing interventions to prevent falls and its recurrence, when patients are admitted to acute care hospitals.
老年住院患者跌倒的原因是多方面的，药物被认为是最重要的因素之一。鉴于这种现象对老年人的生活和相关机构有重大影响，更深入地探讨这一现象很重要。
本研究的目的是探讨药物与跌倒及反复跌倒（n≥2）之间的关联，并确定大型急症医院中住院患者与药物相关的跌倒风险。
2008年6月至2010年12月的回顾性定量研究。
该研究在葡萄牙里斯本一家收治急症患者的私立医院进行。
该研究纳入了193例患者发生的214次跌倒事件通知样本。
本研究通过“面对面共识”技术开展，该技术确定了要调查的治疗组。在数据分析方面，我们使用了学生t检验、方差分析和比值比。在不符合参数统计使用前提的情况下，我们使用了克鲁斯卡尔-沃利斯检验。为评估跌倒风险和与药物相关的跌倒风险，我们使用了莫尔斯跌倒风险量表和药物跌倒风险评分。
接受“中枢神经系统”治疗组药物的患者发生跌倒风险的可能性高出10倍（比值比9.90，95%置信区间1.6 - 60.63）。在接受氟哌啶醇和接受曲马多治疗反复跌倒的患者中，发现跌倒（比值比6.09，95%置信区间1.30 - 28.54）与其复发（比值比3.32，95%置信区间1.61 - 6.85）之间存在关联。34%的患者药物跌倒风险评分为6或更高。
本研究能够确定与药物相关的跌倒风险因素，护士在为入住急症医院的患者开处预防跌倒及其复发的干预措施时应予以考虑。
