Predictors of falls and hospitalization outcomes in elderly patients admitted to an acute geriatric unit.
Arch Gerontol Geriatr. 2009 Jul-Aug;49(1):142-5
Authors: Corsinovi L, Bo M, Ricauda Aimonino N, Marinello R, Gariglio F, Marchetto C, Gastaldi L, Fissore L, Zanocchi M, Molaschi M
We aimed to identify fall incidence, predictors and characteristics and to investigate hospitalization outcomes for elderly inpatients. In 340 men and 280 women consecutively admitted to a Acute Geriatric Ward of a University Hospital the following variables were evaluated: demographics, clinical history, main disease responsible for hospitalization, comorbidity (cumulative illness rating scale: CIRS 1 and 2) gait and balance deficit (Tinetti's scales), cognition/function (short portable mental status questionnaire: SPMSQ); activities of daily living: ADL; instrumental activities of daily living: IADL; delirium (confusion assessment method: CAM), drugs administered during hospitalization. Overall 80 falls occurred in 70 patients. The incidence rate of falls was of 6.0 per 1000 patient-days with 2.0 falls per bed/year. Age (relative risk=RR=1.050; 95% confidence interval=CI=1.013-1.087), delirium (RR=3.577; 95% CI 1.096-11.672), diabetes (RR=5.913; 95% CI 1.693-20.644), balance deficit (RR=0.914; 95% CI 0.861-0.970) and polypharmacy (RR=1.226; 95% CI 1.122-1.340) were independently predictive of falling. Fallers had a prolonged length of stay (LOS) (35.5+/-47.8 days vs. 23.2+/-27.2; p=0.01) and more frequent nursing home placements (12.9% vs.5.6%; p<0.005). The knowledge of falling predictors might help in planning specific preventive strategies to improve the patients' global health status and to reduce the costs of medical care.
PMID: 18674824 [PubMed - indexed for MEDLINE]