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Geriatric falls in the context of a hospital fall prevention program: delirium, low body mass index, and other risk factors

BACKGROUND: Inpatient geriatric falls are a frequent complication of hospital care that results in significant morbidity and mortality. OBJECTIVE: Evaluate factors associated with falls in geriatric inpatients after implementation of the fall prevention program. METHODS: Prospective observational st...

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Autores principales: Mazur, Katarzyna, Wilczyński, Krzysztof, Szewieczek, Jan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5027952/
https://www.ncbi.nlm.nih.gov/pubmed/27695303
http://dx.doi.org/10.2147/CIA.S115755
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author Mazur, Katarzyna
Wilczyński, Krzysztof
Szewieczek, Jan
author_facet Mazur, Katarzyna
Wilczyński, Krzysztof
Szewieczek, Jan
author_sort Mazur, Katarzyna
collection PubMed
description BACKGROUND: Inpatient geriatric falls are a frequent complication of hospital care that results in significant morbidity and mortality. OBJECTIVE: Evaluate factors associated with falls in geriatric inpatients after implementation of the fall prevention program. METHODS: Prospective observational study comprised of 788 consecutive patients aged 79.5±7.6 years ( [Formula: see text] ± standard deviation) (66% women and 34% men) admitted to the subacute geriatric ward. Comprehensive geriatric assessment (including Mini-Mental State Examination, Barthel Index of Activities of Daily Living, and modified Get-up and Go Test) was performed. Confusion Assessment Method was used for diagnosis of delirium. Patients were categorized into low, moderate, or high fall risk groups after clinical and functional assessment. RESULTS: About 15.9%, 21.1%, and 63.1% of participants were classified into low, moderate, and high fall risk groups, respectively. Twenty-seven falls were recorded in 26 patients. Increased fall probability was associated with age ≥76 years (P<0.001), body mass index (BMI) <23.5 (P=0.007), Mini-Mental State Examination <20 (P=0.004), Barthel Index <65 (P=0.002), hemoglobin <7.69 mmol/L (P=0.017), serum protein <70 g/L (P=0.008), albumin <32 g/L (P=0.001), and calcium level <2.27 mmol/L. Four independent factors associated with fall risk were included in the multivariate logistic regression model: delirium (odds ratio [OR] =7.33; 95% confidence interval [95% CI] =2.76–19.49; P<0.001), history of falls (OR =2.55; 95% CI =1.05–6.19; P=0.039), age (OR =1.14; 95% CI =1.05–1.23; P=0.001), and BMI (OR =0.91; 95% CI =0.83–0.99; P=0.034). CONCLUSION: Delirium, history of falls, and advanced age seem to be the primary risk factors for geriatric falls in the context of a hospital fall prevention program. Higher BMI appears to be associated with protection against inpatient geriatric falls.
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spelling pubmed-50279522016-09-30 Geriatric falls in the context of a hospital fall prevention program: delirium, low body mass index, and other risk factors Mazur, Katarzyna Wilczyński, Krzysztof Szewieczek, Jan Clin Interv Aging Original Research BACKGROUND: Inpatient geriatric falls are a frequent complication of hospital care that results in significant morbidity and mortality. OBJECTIVE: Evaluate factors associated with falls in geriatric inpatients after implementation of the fall prevention program. METHODS: Prospective observational study comprised of 788 consecutive patients aged 79.5±7.6 years ( [Formula: see text] ± standard deviation) (66% women and 34% men) admitted to the subacute geriatric ward. Comprehensive geriatric assessment (including Mini-Mental State Examination, Barthel Index of Activities of Daily Living, and modified Get-up and Go Test) was performed. Confusion Assessment Method was used for diagnosis of delirium. Patients were categorized into low, moderate, or high fall risk groups after clinical and functional assessment. RESULTS: About 15.9%, 21.1%, and 63.1% of participants were classified into low, moderate, and high fall risk groups, respectively. Twenty-seven falls were recorded in 26 patients. Increased fall probability was associated with age ≥76 years (P<0.001), body mass index (BMI) <23.5 (P=0.007), Mini-Mental State Examination <20 (P=0.004), Barthel Index <65 (P=0.002), hemoglobin <7.69 mmol/L (P=0.017), serum protein <70 g/L (P=0.008), albumin <32 g/L (P=0.001), and calcium level <2.27 mmol/L. Four independent factors associated with fall risk were included in the multivariate logistic regression model: delirium (odds ratio [OR] =7.33; 95% confidence interval [95% CI] =2.76–19.49; P<0.001), history of falls (OR =2.55; 95% CI =1.05–6.19; P=0.039), age (OR =1.14; 95% CI =1.05–1.23; P=0.001), and BMI (OR =0.91; 95% CI =0.83–0.99; P=0.034). CONCLUSION: Delirium, history of falls, and advanced age seem to be the primary risk factors for geriatric falls in the context of a hospital fall prevention program. Higher BMI appears to be associated with protection against inpatient geriatric falls. Dove Medical Press 2016-09-14 /pmc/articles/PMC5027952/ /pubmed/27695303 http://dx.doi.org/10.2147/CIA.S115755 Text en © 2016 Mazur et al. This work is published and licensed by Dove Medical Press Limited The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
spellingShingle Original Research
Mazur, Katarzyna
Wilczyński, Krzysztof
Szewieczek, Jan
Geriatric falls in the context of a hospital fall prevention program: delirium, low body mass index, and other risk factors
title Geriatric falls in the context of a hospital fall prevention program: delirium, low body mass index, and other risk factors
title_full Geriatric falls in the context of a hospital fall prevention program: delirium, low body mass index, and other risk factors
title_fullStr Geriatric falls in the context of a hospital fall prevention program: delirium, low body mass index, and other risk factors
title_full_unstemmed Geriatric falls in the context of a hospital fall prevention program: delirium, low body mass index, and other risk factors
title_short Geriatric falls in the context of a hospital fall prevention program: delirium, low body mass index, and other risk factors
title_sort geriatric falls in the context of a hospital fall prevention program: delirium, low body mass index, and other risk factors
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5027952/
https://www.ncbi.nlm.nih.gov/pubmed/27695303
http://dx.doi.org/10.2147/CIA.S115755
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