Is It Possible to Identify Risks for Injurious Falls in Hospitalized Patients?
Is It Possible to Identify Risks for Injurious Falls in Hospitalized Patients?
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DOI：
10.1016/s1553-7250(12)38052-5
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发表时间：
2012-09-01
影响因子：
2.3
通讯作者：
Shorr, Ronald I.
中科院分区：
文献类型：
--
作者：
Mion, Lorraine C.;Chandler, A. Michelle;Shorr, Ronald I.
背景资料：患者福尔斯跌倒是最常报告的医院不良事件之一，在美国每年发生超过100万例;约10%导致严重损伤。一项回顾性研究，以确定预测因素和结果之间的一个队列的成年住院patients.Methods：数据获得有关患者谁持续在26个月期间，从16个成人普通内科和外科单位在城市大学附属社区医院在医院首次跌倒。内在（个人）因素，外在（环境）因素和情境活动的数据收集通过护士和病人的访谈，病人的检查，事件报告和电子健康记录的审计。跌倒损伤分类为无/任何进行分析。未调整的比值比[OR]和95%置信区间[CI]为每个变量的利益与跌倒injure.Results：784例患者的中位年龄为63.5岁（范围，20至> 90岁），390（50%）是女性，526（67%）是黑人。大约228名（29%）跌倒者受伤;白色患者（OR：2.23; 95% CI：1.62，3.08），或给予选择性5-羟色胺再摄取抑制剂（OR：1.04; 95% CI：1.04，2.67），两种抗精神病药物（OR：3.26; 95% CI：1.20，8.90），阿片类药物（OR：1.59; 95%; CI：1.14，2.20）或利尿剂非抗高血压药物（OR：1.53; 95% CI：1.03，2.26）更有可能维持损伤。在家中使用轮椅可保护跌倒损伤（OR：0.20; 95%CI：0.05，0.84）。百分之七十九的患者已被指定为“高”跌倒风险在24小时内fall.Conclusions：几个变量能够区分谁持续受伤后，医院跌倒的患者，进一步挑战临床医生的努力，以尽量减少医院相关的跌倒伤害。
Background: Patient falls are among the most commonly reported adverse hospital events with more than one million occurring annually in the United States; approximately 10% result in serious injury. A retrospective study was conducted to determine predictors and outcomes of fall injuries among a cohort of adult hospitalized patients.Methods: Data were obtained regarding patients who sustained an initial fall in hospital during a 26-month period from 16 adult general medical and surgical units in an urban university-affiliated community hospital. Data on intrinsic (individual) factors, extrinsic (environmental) factors, and situational activities were collected via nurse and patient interviews, patient examinations, and audits of incident reports and electronic health records. Fall injuries were classified as none/any for analyses. Unadjusted odds ratios [ORs] and 95% confidence intervals [CIs] for each of the variables of interest with fall injury were generated using logistic regressions.Results: The 784 patients had a median age of 63.5 years (range, 20 to > 90 years), 390 (50%) were women, and 526 (67%) were black. Some 228 (29%) fallers sustained injury; patients who were white (OR: 2.23; 95% CI: 1.62, 3.08), or were administered a selective serotonin reuptake inhibitor (OR: 1.04; 95% CI: 1.04, 2.67), two antipsychotic agents (OR: 3.26; 95% CI: 1.20, 8.90), an opiate (OR: 1.59; 95%; CI: 1.14, 2.20), or a diuretic non-antihypertensive agent (OR: 1.53; 95% CI: 1.03, 2.26) were more likely to sustain an injury. Home-based wheelchair use was protective of fall injury (OR: 0.20; 95% CI: 0.05, 0.84). Seventy-nine percent of the patients had been designated as "high" fall risk within 24 hours before the fall.Conclusions: Few variables were able to distinguish patients who sustained injury after a hospital fall, further challenging clinicians' efforts to minimize hospital-related fall injury.