Characteristics of the Fall-Prone Patient
ABSTRACT Interviews, observational data, and quantitative data on physical condition were collected on 100 hospitalized patients at the time of a fall and compared with data from 100 randomly selected patients who had not fallen. Those who had fallen were more likely to have had a previous fall, presence of a secondary diagnosis, intravenous therapy, impaired gait, used walking aids, and have a poor mental status. Correctly classified by these variables were 80.5% of the patients. Examination of the falls and the false negative group revealed three types of patient falls: physiological anticipated, physiological unanticipated, and accidental falls. Appropriate preventive strategies for each type of fall are suggested.
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ABSTRACT: When a hospitalized older patient falls or develops delirium, there are significant consequences for the patient and the health care system. Assessments of inattention and altered consciousness, markers for delirium, were analyzed to determine if they were also associated with falls. This retrospective case-control study from a regional tertiary Veterans Affairs referral center identified falls and delirium risk factors from quality databases from 2010 to 2012. Older fallers with complete delirium risk assessments prior to falling were identified. As a control, non-fallers were matched at a 3:1 ratio. Admission risk factors that were compared in fallers and non-fallers included altered consciousness, cognitive performance, attention, sensory deficits, and dehydration. Odds ratio (OR) was reported (95% confidence interval [CI]). After identifying 67 fallers, the control population (n=201) was matched on age (74.4±9.8 years) and ward (83.6% medical; 16.4% intensive care unit). Inattention as assessed by the Months of the Year Backward test was more common in fallers (67.2% versus 50.8%, OR=2.0; 95% CI: 1.1-3.7). Fallers tended to have altered consciousness prior to falling (28.4% versus 12.4%, OR=2.8; 95% CI: 1.3-5.8). In this case-control study, alterations in consciousness and inattention, assessed prior to falling, were more common in patients who fell. Brief assessments of consciousness and attention should be considered for inclusion in fall prediction.Clinical Interventions in Aging 01/2014; 9:2013-8. DOI:10.2147/CIA.S71033 · 1.82 Impact Factor