Falls following discharge after an in-hospital fall.
Falls following discharge after an in-hospital fall.
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DOI：
10.1186/1471-2318-9-53
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发表时间：
2009-12-01
期刊：
影响因子：
4.1
通讯作者：
Shorr, Ronald I
中科院分区：
文献类型：
--
作者：
Davenport, Rick D;Vaidean, Georgeta D;Shorr, Ronald I
背景：福尔斯是住院患者中最常见的不良事件。虽然有越来越多的文献在医院跌倒预防，数据检查跌倒率和福尔斯的危险因素，在住院后的时间没有得到很好的描述。本研究的目的是确定下降率的住院跌倒者在家里，并探讨福尔斯的危险因素，在立即住院后period.METHODS：我们确定了患者谁持续下降的16个内科/外科护理单位住院期间入院到城市社区教学医院。出院后，通过每周电话监测确定福尔斯，持续出院后4周。对患者进行随访，直至死亡、失访或研究结束（4周）。花费再住院或制度化的时间被审查率calculation.RESULTS：95住院患者下降招募期间，65（68%）符合纳入标准，并同意参加。这些受试者为研究贡献了1498人-天（平均随访持续时间= 23天）。75%是非洲裔美国人，43%是女性。16例患者（25%）在住院期间发生多次福尔斯，23例患者（35%）在住院期间发生跌倒相关损伤。19例患者（29%）在家中发生38次福尔斯跌倒，跌倒率为25.4/1000人-天（95% CI：17.3-33.4）。23例患者（35%）再次入院，3例（5%）死亡。1例患者发生髋部骨折。在探索性单变量分析中，可能在家中跌倒的人是那些在医院中多次福尔斯的人（p = 0.008）。结论：住院期间跌倒的患者，尤其是多次跌倒的患者，出院后在家中跌倒的风险较高。减少福尔斯跌倒的干预措施适合在该高风险人群中进行测试。
BACKGROUND: Falls are among the most common adverse events reported in hospitalized patients. While there is a growing body of literature on fall prevention in the hospital, the data examining the fall rate and risk factors for falls in the immediate post-hospitalization period has not been well described. The objectives of the present study were to determine the fall rate of in-hospital fallers at home and to explore the risk factors for falls during the immediate post-hospitalization period.METHODS: We identified patients who sustained a fall on one of 16 medical/surgical nursing units during an inpatient admission to an urban community teaching hospital. After discharge, falls were ascertained using weekly telephone surveillance for 4 weeks post-discharge. Patients were followed until death, loss to follow up or end of study (four weeks). Time spent rehospitalized or institutionalized was censored in rate calculations.RESULTS: Of 95 hospitalized patients who fell during recruitment, 65 (68%) met inclusion criteria and agreed to participate. These subjects contributed 1498 person-days to the study (mean duration of follow-up = 23 days). Seventy-five percent were African-American and 43% were women. Sixteen patients (25%) had multiple falls during hospitalization and 23 patients (35%) suffered a fall-related injury during hospitalization. Nineteen patients (29%) experienced 38 falls at their homes, yielding a fall rate of 25.4/1,000 person-days (95% CI: 17.3-33.4). Twenty-three patients (35%) were readmitted and 3(5%) died. One patient experienced a hip fracture. In exploratory univariate analysis, persons who were likely to fall at home were those who sustained multiple falls in the hospital (p = 0.008).CONCLUSION: Patients who fall during hospitalization, especially on more than one occasion, are at high risk for falling at home following hospital discharge. Interventions to reduce falls would be appropriate to test in this high-risk population.