Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia.
Cork University Hospital, Cork, Ireland.
Australas J Ageing. 2023 Sep;42(3):598-602. doi: 10.1111/ajag.13177. Epub 2023 Mar 14.
Falls with fracture in hospitalised patients remain a common occurrence with significant morbidity and mortality. Our objectives were to determine the characteristics of patients who suffer falls with fractures in hospital, and to examine whether outcomes in this cohort differ from those of patients who fall without sustaining a fracture.
Coding data pertaining to a 6-year period (2012-2017) were interrogated. Patients coded as having suffered a fall in hospital during this period were identified and divided into those who did and those who did not suffer fractures due to their fall. Patient demographics and comorbidities were compared between groups and outcome measures examined with descriptive statistics and binary logistic regression.
From 236,720 inpatient admissions, 721 falls were recorded, 128 of which were associated with a fracture. Delirium (30% in those who suffered a fracture vs. 21% in those who did not, p < 0.040), dementia (23% vs. 13%, p < 0.004), female sex (53% vs. 44%, p < 0.020) and older age (76.8 vs. 72.8 years, p < 0.010) were associated with falls with fractures in hospital. Falls with fractures were associated with a longer length of inpatient stay by 9.2 days (95% CI 5.5-12.9, p < 0.001) and were an independent predictor of inpatient mortality.
Greater understanding of characteristics of patients at risk of falls with fractures, as well as knowledge of the considerable associated morbidity and mortality, will help to prognosticate when these events occur and, potentially, to put preventative measures in place.
住院患者发生骨折性跌倒仍然较为常见，会导致较高的发病率和死亡率。本研究旨在确定发生骨折性跌倒的住院患者的特征，并探讨该人群的结局是否与未发生骨折的跌倒患者存在差异。
我们对 6 年期间（2012-2017 年）的编码数据进行了查询。确定在此期间发生院内跌倒且编码为跌倒的患者，并将其分为发生骨折和未发生骨折的两组。比较两组患者的人口统计学特征和合并症，并使用描述性统计和二元逻辑回归分析评估结局指标。
在 236720 例住院患者中，共记录到 721 例跌倒事件，其中 128 例与骨折相关。与未发生骨折的跌倒患者相比，发生骨折性跌倒的患者更易出现谵妄（30% vs. 21%，p<0.040）、痴呆（23% vs. 13%，p<0.004）、女性（53% vs. 44%，p<0.020）和高龄（76.8 岁 vs. 72.8 岁，p<0.010）。发生骨折性跌倒与住院时间延长 9.2 天相关（95%CI 5.5-12.9，p<0.001），并且是住院期间死亡的独立预测因素。
更好地了解有骨折性跌倒风险的患者的特征，以及了解其相关的高发病率和死亡率，有助于在这些事件发生时进行预后评估，并可能采取预防措施。
