Department of Orthopaedic Surgery, National Hospital Organization Kofu National Hospital, Kofu, Japan.
Department of Orthopaedic Surgery, Faculty of Medicine, University of Yamanashi, Chuo, Japan.
Nagoya J Med Sci. 2022 May;84(2):311-318. doi: 10.18999/nagjms.84.2.311.
Falls (including fall on same level and fall to a lower level) are frequent medical accidents among hospitalized patients. We investigated the status of falls in our hospital, aiming to verify the usefulness of a fall risk assessment sheet and identify the risk factors of falls. 5219 patients who were admitted to the general wards of our hospital between April 2016 and March 2019 were studied. Patient background data and the result of risk assessment based on a fall risk assessment score sheet at admission were registered. The frequency and location of falls during hospitalization, and the impact on patients were investigated. Risk factors for falls were analyzed based on the assessment results at admission. 218 falls occurred during hospitalization in 152 of 5219 patients (2.9%). The most common location of falls was bedside (68%). Falls occurred at night in 28%. The impact of falls was level 1 in 18 patients, level 2 in 117, level 3a in 11, and level 3b in 6 (all had head injuries, and one had concurrent fracture). Fall rate was 1.1% (41/3791 patients) at risk level I, 6.8% (91/1335 patients) at level II, and 21.5% (20/93 patients) at level III. Multiple logistic regression analysis identified age, history of fall, tendency to act without pressing nurse call button, unstable gait, unstable when standing, and use of narcotic as risk factors of falls. The incidence of falls at our hospital was lower compared to previous reports, and fall risk assessment was useful overall.
跌倒（包括同一平面跌倒和跌倒至更低平面）是住院患者中常见的医疗事故。我们调查了我院的跌倒情况，旨在验证跌倒风险评估表的有效性，并确定跌倒的危险因素。研究对象为 2016 年 4 月至 2019 年 3 月期间入住我院普通病房的 5219 名患者。登记患者背景数据和入院时基于跌倒风险评估评分表的风险评估结果。调查住院期间跌倒的频率和地点，以及对患者的影响。根据入院评估结果分析跌倒的危险因素。在 5219 名患者中，有 152 名（2.9%）患者在住院期间发生了 218 次跌倒。最常见的跌倒地点是床边（68%）。28%的跌倒发生在夜间。18 例跌倒的影响为 1 级，117 例为 2 级，11 例为 3a 级，6 例为 3b 级（均有头部受伤，1 例伴有骨折）。风险级别 I 的跌倒发生率为 1.1%（41/3791 例），级别 II 为 6.8%（91/1335 例），级别 III 为 21.5%（20/93 例）。多因素逻辑回归分析确定年龄、跌倒史、不按呼叫铃习惯、步态不稳、站立不稳和使用麻醉剂是跌倒的危险因素。与以往报告相比，我院跌倒发生率较低，整体而言，跌倒风险评估是有效的。
