From the Department of Nursing, Asan Medical Center.
College of Nursing, Seoul National University, Seoul, Korea.
J Patient Saf. 2020 Dec;16(4):e376-e382. doi: 10.1097/PTS.0000000000000593.
The purpose of this study was to explore the characteristics and predictors of falls in high- and low-risk inpatients in a tertiary hospital in Korea.
Fallers' data were extracted from quality improvement reports and electronic health records from June 1, 2014, to May 31, 2015. Data on nonfallers matched by the length of hospitalization and medical departments of fallers were extracted from electronic health records. Participants were classified into a high- or a low-risk group based on their Morse Fall Scale score, fall risk-related symptoms, and medications known to increase fall risk. Characteristics of falls and risk factors were analyzed using descriptive statistics and logistic regression analysis, respectively.
In the high-risk group, education, surgery, department, impaired mobility, intravenous catheter placement, use of ambulatory aid, gait disturbance, and some medications were significantly different between the fallers and nonfallers. From these variables, education, operation, department, intravenous catheter placement, gait disturbance, and use of narcotics, vasodilators, antiarrhythmics, and hypnotics were statistically significant factors for falls. In the low-risk group, sex, age, length of hospitalization, surgery, department, diagnosis, and mental status were significantly different between the fallers and nonfallers. From these, sex, age, length of hospitalization, surgery, and liver-digestive diseases were statistically significant factors for falls.
Characteristics and risk factors for falls differed between the risk groups. Fall prevention strategies need to be tailored to the risk groups and fall risk assessment tools need to be revised accordingly.
本研究旨在探讨韩国一家三级医院中高风险和低风险住院患者跌倒的特征和预测因素。
从 2014 年 6 月 1 日至 2015 年 5 月 31 日的质量改进报告和电子病历中提取跌倒患者的数据。从电子病历中提取与住院时间和跌倒患者的医疗科室相匹配的非跌倒患者的数据。根据 Morse 跌倒量表评分、与跌倒风险相关的症状以及已知增加跌倒风险的药物，将参与者分为高风险或低风险组。使用描述性统计和逻辑回归分析分别分析跌倒的特征和危险因素。
在高风险组中，教育、手术、科室、活动能力受损、静脉置管、使用助行器、步态障碍和一些药物在跌倒患者和非跌倒患者之间存在显著差异。从这些变量中，教育、手术、科室、静脉置管、步态障碍和使用麻醉剂、血管扩张剂、抗心律失常药和催眠药是与跌倒相关的统计学显著因素。在低风险组中，性别、年龄、住院时间、手术、科室、诊断和精神状态在跌倒患者和非跌倒患者之间存在显著差异。其中，性别、年龄、住院时间、手术和肝-消化系统疾病是与跌倒相关的统计学显著因素。
高风险和低风险组的跌倒特征和危险因素不同。需要针对风险组制定预防跌倒策略，并相应修订跌倒风险评估工具。
