Department of Anesthesiology, Buddhist Tzu Chi General Hospital and Tzu Chi University School of Medicine, No 707, Chung-Yang Road Section 3, Hualien, 970 Taiwan Republic of China.
Department of Medical Research, Tzu Chi General Hospital, Hualien, Taiwan.
Perioper Med (Lond). 2016 May 23;5:11. doi: 10.1186/s13741-016-0038-z. eCollection 2016.
In-hospital falls may result in serious clinical adverse consequences, but the effects of anesthesia in the occurrence of postoperative falls are still undetermined. Anesthesia may theoretically cause postoperative falls due to the residual pharmacologic and neuromuscular blocking effects of anesthetics. We retrospectively reviewed events of in-hospital falls occurred after anesthesia management to identify the incidence and risk factors of postanesthesia falls.
We reviewed the postanesthesia visit of patients received anesthesia in the Hualien Buddhist Tzu Chi General Hospital from January 2009 to December 2013. Falls happened within 24 h after anesthesia were recorded. The Poisson regression model was used for simultaneous analysis of the association between incidence proportion of postanesthesia falls and the potential risk factors.
A total of 60,796 inpatients received anesthesia management over the past 5 years, and ten patients fell within 24 h after anesthesia. All cases happened in the general wards. Falls occurred more often at the bedside, presence of caregivers, and during the daytime. Patients underwent regional anesthesia, and old age significantly increased the risk of postanesthesia falls, while differences in gender and ASA physical status did not affect the occurrence of postanesthesia falls.
The overall incidence proportion of postanesthesia falls is 1.6 cases per 10,000 patients (95 % CI 0.006 to 0.026 %) over a 24-h observation period. Falls are more commonly happened during the less expected periods after operation and are increased in the elderly and patients received regional anesthesia. This study highlights that more comprehensive clinical practice guidelines for postoperative care should be exercised to prevent the in-hospital falls.
院内跌倒可能导致严重的临床不良后果，但麻醉在术后跌倒发生中的作用仍不确定。理论上，麻醉可能会因麻醉药物的残留药理和神经肌肉阻滞作用而导致术后跌倒。我们回顾性分析了麻醉管理后发生的院内跌倒事件，以确定术后跌倒的发生率和危险因素。
我们回顾了 2009 年 1 月至 2013 年 12 月在花莲慈济医院接受麻醉的患者的麻醉后访视。记录麻醉后 24 小时内发生的跌倒事件。使用泊松回归模型同时分析术后跌倒发生率与潜在危险因素之间的关联。
在过去的 5 年中，共有 60796 名住院患者接受了麻醉管理，有 10 名患者在麻醉后 24 小时内跌倒。所有病例均发生在普通病房。跌倒更常发生在床边、有护理人员在场和白天。接受区域麻醉和年龄较大的患者术后跌倒风险显著增加，而性别和 ASA 身体状况的差异并不影响术后跌倒的发生。
在 24 小时观察期内，术后跌倒的总体发生率为每 10000 例患者 1.6 例（95%CI0.006 至 0.026%）。跌倒更常见于术后预期较低的时间段，并且在老年人和接受区域麻醉的患者中增加。本研究强调，应制定更全面的术后护理临床实践指南，以预防院内跌倒。
