Predictors of serious injury among hospitalized patients evaluated for falls

Sara M. Bradley, Reena Karani, Thomas McGinn, Juan Wisnivesky

Research output: Contribution to journalArticle

20 Scopus citations

Abstract

BACKGROUND: Inpatient falls are common and result in significant patient morbidity. OBJECTIVE: To identify predictors of serious injury being found on imaging studies of inpatients evaluated after a fall. DESIGN: Retrospective study. SETTING: An 1171-bed urban academic medical center. PATIENTS: All inpatients who fell on thirteen medical and surgical units from January 1 to December 31, 2006. MEASUREMENTS: Patient characteristics, circumstances surrounding falls, fall-related injuries, and length of stay were collected through review of incident reports and computerized medical records. Primary outcome of fall-related injury was determined by evidence of injury on imaging studies within two weeks of the fall. Univariate and multivariate logistic regression were used to calculate adjusted odds ratios (ORs) for injury after an inpatient fall. RESULTS: A total of 513 patients had 636 falls during the study time period. Fall incidence rate was 1.97 falls per 1,000 patient days. 95 patients (19%) fell multiple times (range, 2-6 events); 74% of the falls occurred in patients who were previously assessed as being "at risk" by the nursing staff. Multivariate analysis, adjusting for age and sex, found evidence of trauma after a fall (OR = 24.6, P < 0.001) and ambulatory status (OR = 7.3, P < 0.01) to be independent predictors of injury being found on imaging studies. CONCLUSIONS: Inpatient falls are common despite high-risk patients being identified. After adjusting for age and sex, evidence of trauma and ambulatory status were independent predictors of an injury being found on imaging studies after an inpatient fall.

Original languageEnglish (US)
Pages (from-to)63-68
Number of pages6
JournalJournal of Hospital Medicine
Volume5
Issue number2
DOIs
StatePublished - Feb 1 2010

Keywords

  • Fall prevention
  • Injury
  • Inpatient falls

ASJC Scopus subject areas

  • Leadership and Management
  • Fundamentals and skills
  • Health Policy
  • Care Planning
  • Assessment and Diagnosis

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