Kinoshita Tokio, Nishimura Yukihide, Umemoto Yasunori, Kawasaki Shinji, Yasuoka Yoshinori, Minami Kohei, Koike Yumi, Tajima Fumihiro
Department of Rehabilitation Medicine, Wakayama Medical University, Wakayama, Japan.
Department of Rehabilitation Medicine, Iwate Medical University, Morioka, Japan.
Front Med (Lausanne). 2022 Aug 17;9:969457. doi: 10.3389/fmed.2022.969457. eCollection 2022.
Although falls are often reported in hospitals and are common in older individuals, no reports on falls during rehabilitation exist. This study evaluated patients with falls occurring during rehabilitation and identified the characteristics of older and non-older patients.
Our study retrospectively analyzed reports of falls occurring during rehabilitation at a university hospital from April 1, 2020 to March 31, 2022. The survey items included the number of falls in the hospital as a whole and during rehabilitation, age, gender, modified Rankin Scale (mRS) before admission and at the time of fall, functional independence measure (FIM) at admission, patient communication status at the time of fall, and whether a therapist was near the patient. Patients aged ≥ 65 were considered older; aged ≤ 64, non-older; and those with the same age, gender, and clinical department, randomly selected as non-falling patients.
Thirty-five falls occurred during rehabilitation (14 in the non-older and 21 in the older patients), significantly lower than the 945 for the entire hospital, without any significant difference between non-older and older patients. No significant differences in mRS before admission and FIM at admission were noted for both groups in comparison with the non-falling patient group. Furthermore, gender, mRS, FIM, good communication status, and presence of therapist near the patient were similar between non-older and older patients (non-older 71.4%, older 52.4%). Most falls were minor adverse events that did not require additional treatment.
The rate of falls during rehabilitation was much lower than that during hospitalization, and many falls had minimal impact on the patient. It was also difficult to predict falls in daily life and communication situations, and there was no difference in characteristics between the older and non-older groups. Since more than half of the falls occurred during training with the therapist, it is necessary to reconsider the training content.
尽管医院中经常报告跌倒事件，且在老年人中很常见，但尚无关于康复期间跌倒的报告。本研究评估了康复期间发生跌倒的患者，并确定了老年和非老年患者的特征。
我们的研究回顾性分析了2020年4月1日至2022年3月31日期间在一家大学医院康复期间发生跌倒的报告。调查项目包括医院整体和康复期间的跌倒次数、年龄、性别、入院前和跌倒时的改良Rankin量表（mRS）、入院时的功能独立性测量（FIM）、跌倒时的患者沟通状态以及患者附近是否有治疗师。年龄≥65岁的患者被视为老年人；年龄≤64岁的患者为非老年人；年龄、性别和临床科室相同的患者被随机选为未跌倒患者。
康复期间发生了35起跌倒事件（非老年患者14起，老年患者21起），明显低于整个医院的945起，老年和非老年患者之间无显著差异。与未跌倒患者组相比，两组入院前的mRS和入院时的FIM均无显著差异。此外，非老年和老年患者在性别、mRS、FIM、良好的沟通状态以及患者附近有治疗师方面相似（非老年患者71.4%，老年患者52.4%）。大多数跌倒为轻微不良事件，无需额外治疗。
康复期间的跌倒发生率远低于住院期间，且许多跌倒对患者影响极小。在日常生活和沟通情况下也难以预测跌倒，老年组和非老年组在特征上没有差异。由于超过一半的跌倒发生在与治疗师的训练期间，因此有必要重新考虑训练内容。
