Stevenson B, Mills E M, Welin L, Beal K G
Wright State University-Miami Valley College of Nursing and Health, Dayton, Ohio, USA.
Can J Nurs Res. 1998 Spring;30(1):97-111.
Research findings have been contradictory regarding risk factors for falls in the acute-care setting. Identification of factors that place individuals at risk of falling in this setting are a priority because falls result in high morbidity and mortality and thus increased healthcare costs. The purpose of this study was to extend knowledge beyond the known risk factors of age and medical diagnosis by comparing the characteristics of 301 adults who fell while hospitalized with a matched sample of adults who did not fall while hospitalized. A descriptive, retrospective, comparative design was used. The fall and non-fall group were matched on age and primary medical diagnosis at the time of discharge. Data were collected from hospital incident reports and medical records. Logistic regression for matched groups identified 5 risk factors, as follows. Incontinence. The odds of falling were 11.3 (CI = 3.85, 33.05) times greater for those who were incontinent than for those who were not incontinent. Long hospital stay. The odds of falling were 9.9 (CI = 4.89, 19.88) times greater for those hospitalized 19 days or longer than for those hospitalized less than 19 days. Dependency for ambulation. The odds of falling were 6 (CI = 2.83, 12.84) times greater for those who were dependent for ambulation than for those who were independent. Independency for hygiene. The odds of falling were 2.5 (CI = 1.23, 4.88) times greater for those who were independent for hygiene than for those who were dependent. Lack of regular exercise. The odds of falling were twice as high (CI = 1.00, 3.82) for those who did not exercise regularly as for those who exercised regularly. These findings suggest that ongoing assessment may be more important than the admission assessment in identifying risk factors for falls in the acute-care setting. No 2 studies have found exactly the same set of risk factors, although some findings are consistent across studies. This suggests that those risk factors that are consistent across studies may identify persons who are at the greatest risk for falls and that other risk factors for falls are specific to a patient population.
关于急性护理环境中跌倒的风险因素，研究结果一直相互矛盾。确定导致个体在这种环境中跌倒的风险因素是当务之急，因为跌倒会导致高发病率和死亡率，从而增加医疗成本。本研究的目的是通过比较301名住院期间跌倒的成年人与匹配的未在住院期间跌倒的成年人样本的特征，扩展对年龄和医学诊断等已知风险因素之外的认识。采用了描述性、回顾性、比较性设计。跌倒组和未跌倒组在出院时按年龄和主要医学诊断进行匹配。数据从医院事件报告和病历中收集。对匹配组进行的逻辑回归确定了5个风险因素，如下所示。大小便失禁。大小便失禁者跌倒的几率是未大小便失禁者的11.3倍（CI = 3.85, 33.05）。住院时间长。住院19天或更长时间的人跌倒的几率是住院时间少于19天的人的9.9倍（CI = 4.89, 19.88）。行走依赖。行走依赖者跌倒的几率是独立行走者的6倍（CI = 2.83, 12.84）。个人卫生自理。个人卫生自理者跌倒的几率是依赖他人者的2.5倍（CI = 1.23, 4.88）。缺乏定期锻炼。不经常锻炼者跌倒的几率是经常锻炼者的两倍（CI = 1.00, 3.82）。这些发现表明，在识别急性护理环境中跌倒的风险因素方面，持续评估可能比入院评估更重要。尽管有些研究结果是一致的，但没有两项研究发现完全相同的风险因素组合。这表明，那些在各项研究中都一致的风险因素可能能识别出跌倒风险最高的人群，而其他跌倒风险因素则特定于某一患者群体。
