Department of Geriatrics, Faculty of Health Sciences, Medical University of Bialystok, 15-471 Bialystok, Poland.
Department of Geriatrics, Hospital of the Ministry of Interior and Administration in Bialystok, 15-471 Bialystok, Poland.
Int J Environ Res Public Health. 2022 Aug 30;19(17):10789. doi: 10.3390/ijerph191710789.
It is only by knowing the most common causes of falls in the hospital that appropriate and targeted fall prevention measures can be implemented. This study aimed to assess the frequency of falls in a hospital geriatrics ward and the circumstances in which they occurred and evaluate the parameters of the comprehensive geriatric assessment (CGA) correlating with falls. We considered medical, functional, and nutritional factors associated with falls and built multivariable logistic regression analysis models. A total of 416 (median age 82 (IQR 77-86) years, 77.4% women) hospitalizations in the geriatrics ward were analyzed within 8 months. We compared the results of a CGA (including health, psycho-physical abilities, nutritional status, risk of falls, frailty syndrome, etc.) in patients who fell and did not fall. Fourteen falls (3.3% of patients) were registered; the rate was 4.4 falls per 1000 patient days. They most often occurred in the patient's room while changing position. Falls happened more frequently among people who were more disabled, had multimorbidity, were taking more medications (certain classes of drugs in particular), had Parkinson's disease and diabetes, reported falls in the last year, and were diagnosed with orthostatic hypotension. Logistic regression determined the significant independent association between in-hospital falls and a history of falls in the previous 12 months, orthostatic hypotension, Parkinson's disease, and taking statins, benzodiazepines, and insulin. Analysis of the registered falls that occurred in the hospital ward allowed for an analysis of the circumstances in which they occurred and helped to identify people at high risk of falling in a hospital, which can guide appropriate intervention and act as an indicator of good hospital care.
只有了解医院中最常见的跌倒原因，才能实施适当和有针对性的跌倒预防措施。本研究旨在评估医院老年病房跌倒的频率以及发生的情况，并评估与跌倒相关的综合老年评估（CGA）的参数。我们考虑了与跌倒相关的医学、功能和营养因素，并建立了多变量逻辑回归分析模型。在 8 个月内分析了老年病房的 416 次（中位数年龄 82（IQR77-86）岁，77.4%女性）住院情况。我们比较了在跌倒和未跌倒的患者中 CGA（包括健康、心理生理能力、营养状况、跌倒风险、虚弱综合征等）的结果。登记了 14 例跌倒（3.3%的患者）；发生率为每 1000 个患者日 4.4 例。它们最常发生在患者改变体位时的房间内。在残疾程度较高、患有多种疾病、服用更多药物（特别是某些类别的药物）、患有帕金森病和糖尿病、报告过去一年有跌倒史且被诊断为直立性低血压的患者中，跌倒发生的频率更高。逻辑回归确定了住院期间跌倒与过去 12 个月内跌倒史、直立性低血压、帕金森病和服用他汀类药物、苯二氮䓬类药物和胰岛素之间存在显著的独立关联。对医院病房内登记的跌倒进行分析，分析了跌倒发生的情况，有助于确定医院内跌倒风险较高的人群，这可以指导适当的干预措施，并作为良好医院护理的指标。
