Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Department of Quality and Patient Safety, Nagoya University Hospital, Nagoya, Japan.
Geriatr Gerontol Int. 2017 Dec;17(12):2403-2406. doi: 10.1111/ggi.13085. Epub 2017 Jun 28.
Falls are common adverse events for hospitalized elderly patients that can cause fracture, which decreases activities of daily living, and other injuries that can be fatal. The purpose of the present study was to investigate serious events due to fall, and to consider measures for fall prevention.
Incidents of fall were obtained from a database of 163 558 inpatients at Nagoya University Hospital, Nagoya, Aichi, Japan, from April 2012 to March 2016. The risk of fall was evaluated using a fall assessment score sheet at admission and during hospitalization, based on which patients were divided into risk grades 1, 2 and 3. A fall that led to fracture or a life-threatening injury was defined as a serious event.
Fall occurred in 3099 patients for 4 years (1.89%). Most patients that fell (45%) were in the highest (grade 3) risk category. Serious events associated with fall occurred in 36 of the 3099 patients (1.2%), and the overall incidence of serious events was 0.22%. These events included fracture in 24 patients, intracranial injury in 10 patients and others in two patients. Finally, one patient died. Serious events occurred significantly more frequently after falls in patients wearing slippers compared with other footwear (P < 0.01). The incidences of serious events and fall were significantly higher in patients with a higher risk of fall (P < 0.05).
The present results support the validity of our risk assessment scale for fall, but it should be recognized that fall can also occur in a patient with a low predicted risk of fall. Geriatr Gerontol Int 2017; 17: 2403-2406.
跌倒在住院老年患者中较为常见，可导致骨折，从而降低日常生活活动能力，还可能导致其他致命伤害。本研究旨在调查跌倒所致严重事件，并探讨预防跌倒的措施。
本研究从日本爱知县名古屋大学医院的 163558 名住院患者数据库中获取跌倒事件，时间为 2012 年 4 月至 2016 年 3 月。入院时和住院期间使用跌倒评估评分表评估跌倒风险，根据该评分表将患者分为风险等级 1、2 和 3。导致骨折或危及生命的伤害的跌倒被定义为严重事件。
4 年内共有 3099 名患者发生跌倒（1.89%）。大多数跌倒患者（45%）处于最高（等级 3）风险类别。3099 名患者中有 36 例（1.2%）发生与跌倒相关的严重事件，严重事件总发生率为 0.22%。这些事件包括 24 例骨折、10 例颅内损伤和 2 例其他损伤。最终，1 例患者死亡。与穿其他鞋的患者相比，穿拖鞋的患者跌倒后发生严重事件的概率显著更高（P<0.01）。风险较高的患者严重事件和跌倒的发生率显著更高（P<0.05）。
本研究结果支持我们的跌倒风险评估量表的有效性，但应认识到即使是预测跌倒风险较低的患者也可能发生跌倒。老年医学与老年健康国际杂志 2017；17：2403-2406。
