Department of Health Care of Older People, Nottingham University Hospitals NHS Trust, QMC Campus, Derby Road, Nottingham, NG72UH Nottingham, UK.
Age Ageing. 2014 Mar;43(2):247-53. doi: 10.1093/ageing/aft155. Epub 2013 Oct 18.
falls in hospitals are a major problem and contribute to substantial healthcare burden. Advances in sensor technology afford innovative approaches to reducing falls in acute hospital care. However, whether these are clinically effective and cost effective in the UK setting has not been evaluated.
pragmatic, parallel-arm, individual randomised controlled trial of bed and bedside chair pressure sensors using radio-pagers (intervention group) compared with standard care (control group) in elderly patients admitted to acute, general medical wards, in a large UK teaching hospital. Primary outcome measure number of in-patient bedside falls per 1,000 bed days.
1,839 participants were randomised (918 to the intervention group and 921 to the control group). There were 85 bedside falls (65 fallers) in the intervention group, falls rate 8.71 per 1,000 bed days compared with 83 bedside falls (64 fallers) in the control group, falls rate 9.84 per 1,000 bed days (adjusted incidence rate ratio, 0.90; 95% confidence interval [CI], 0.66-1.22; P = 0.51). There was no significant difference between the two groups with respect to time to first bedside fall (adjusted hazard ratio (HR), 0.95; 95% CI: 0.67-1.34; P= 0.12). The mean cost per patient in the intervention group was £7199 compared with £6400 in the control group, mean difference in QALYs per patient, 0.0001 (95% CI: -0.0006-0.0004, P= 0.67).
bed and bedside chair pressure sensors as a single intervention strategy do not reduce in-patient bedside falls, time to first bedside fall and are not cost-effective in elderly patients in acute, general medical wards in the UK.
isrctn.org identifier: ISRCTN44972300.
医院跌倒事件是一个严重的问题，会给医疗保健系统带来巨大的负担。传感器技术的进步为减少急性医院护理中的跌倒事件提供了创新方法。然而，这些方法在英国的临床效果和成本效益是否得到了评估还不得而知。
在英国一家大型教学医院的急性普通内科病房中，对使用无线电寻呼器的床和床边椅子压力传感器（干预组）与标准护理（对照组）进行了实用性、平行臂、个体随机对照试验。主要结局测量每 1000 个卧床日的住院床边跌倒次数。
共有 1839 名参与者被随机分配（干预组 918 人，对照组 921 人）。干预组有 85 例床边跌倒（65 例跌倒者），跌倒率为每 1000 个卧床日 8.71 例；对照组有 83 例床边跌倒（64 例跌倒者），跌倒率为每 1000 个卧床日 9.84 例（调整后的发病率比，0.90；95%置信区间[CI]，0.66-1.22；P=0.51）。两组之间首次床边跌倒的时间无显著差异（调整后的危害比（HR），0.95；95%CI：0.67-1.34；P=0.12）。干预组每位患者的平均费用为 7199 英镑，而对照组为 6400 英镑，每位患者的平均 QALY 差异为 0.0001（95%CI：-0.0006-0.0004，P=0.67）。
作为单一干预策略，床和床边椅子压力传感器不能减少英国急性普通内科病房老年患者的住院床边跌倒、首次床边跌倒的时间，并且在成本效益方面也不可行。
isrctn.org 标识符：ISRCTN44972300。
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