Department of Nursing, Tenri Health Care University, Nara, Japan.
Department of Epidemiology, Nara Medical University School of Medicine, Nara, Japan.
J Am Med Dir Assoc. 2020 Apr;21(4):476-480. doi: 10.1016/j.jamda.2019.07.006. Epub 2019 Aug 22.
Comparing the incidence rate of in-hospital falls between patients hospitalized in window beds and nonwindow beds.
Retrospective cohort study.
A general hospital in Mie, Japan.
A total of 2767 patients (mean age, 68.4 years) hospitalized in four-bedded rooms between January 2014 and December 2016.
We identified patients' bed status (window/nonwindow) and the incidence of in-hospital falls using data on medical records and incidence reports, respectively.
During an observation period of 25,450 person-days, 57 patients had in-hospital falls (incidence rate, 2.24/1000 person-days). Incidence rate for in-hospital falls was significantly lower in the window-bed group (n = 1273) than in the nonwindow-bed group (n = 1494) [incidence rate ratio (IRR) 0.49, 95% confidence interval (CI), 0.29, 0.84]. In the multivariable analysis adjusted for age, gender, BMI, smoking and drinking habit, surgical operation during hospitalization, and independence in daily living, the window-bed group exhibited significantly lower incidence rate for in-hospital falls than the nonwindow-bed group (IRR 0.54, 95% CI 0.32, 0.93). Sensitivity analysis excluding patients aged <60 years suggested a consistent result: incidence rate for in-hospital falls was significantly lower in the window-bed group (n = 1123) than in the nonwindow-bed group (n = 925) (IRR 0.55, 95% CI 0.31, 0.95).
The incidence rate of in-hospital falls was significantly lower among patients hospitalized in window beds than nonwindow beds. Hospitalization in window beds might be a novel, simple preventive option for in-hospital falls. Further large-scale, prospective, multicenter research is required.
比较住在窗床和非窗床的住院患者的院内跌倒发生率。
回顾性队列研究。
日本三重县的一家综合医院。
2014 年 1 月至 2016 年 12 月期间,在四人间病房住院的 2767 名患者(平均年龄 68.4 岁)。
我们分别使用病历数据和事件报告来确定患者的床位状态(窗床/非窗床)和院内跌倒的发生率。
在 25450 人天的观察期内,共有 57 名患者发生院内跌倒(发生率为 2.24/1000 人天)。窗床组(n=1273)的院内跌倒发生率明显低于非窗床组(n=1494)[发生率比(IRR)0.49,95%置信区间(CI)0.29,0.84]。在校正年龄、性别、BMI、吸烟和饮酒习惯、住院期间手术以及日常生活自理能力后,窗床组的院内跌倒发生率明显低于非窗床组(IRR 0.54,95%CI 0.32,0.93)。排除年龄<60 岁的患者进行敏感性分析后,结果一致:窗床组(n=1123)的院内跌倒发生率明显低于非窗床组(n=925)(IRR 0.55,95%CI 0.31,0.95)。
住在窗床的住院患者的院内跌倒发生率明显低于住在非窗床的患者。住院期间使用窗床可能是预防院内跌倒的一种新的简单方法。需要进一步开展大规模、前瞻性、多中心研究。